继发性脑室出血脑循环动力学参数检测及尼莫地平的干预效果

Intervention Effect of Nimodipine Treating the Patients with Secondary Intraventricular Hemorrhage by Detecting CVHI

目的探讨继发性脑室出血患者的循环动力学状况及尼莫地平的干预效果。方法用随机法将继发性脑室出血患者分成尼莫地平组(常规治疗+尼莫地平)和常规组(常规治疗)。检测并比较两组患者治疗前后双侧的脑循环动力学参数(CVHI),观察颅脑CT片上的血肿量、水肿面积及治疗有效率。结果两组患者患侧平均血流速度(Vmean)、平均血流量(Qmean)、血管阻力(R)及临界压力(CP)与健侧比较,差别有统计学意义(P<0.05)。尼莫地平组治疗后除了健侧Qmean外,Vmean、患侧Qmean、R及CP与本组治疗前同侧比较,差别有统计学意义(P<0.05);常规组治疗后的患侧Qmean、R及患侧CP与本组治疗前同侧比较,差别有统计学意义(P<0.05)。治疗后尼莫地平组健侧Qmean、R及CP与常规组比较,差别有统计学意义(P<0.05)。两组患者治疗前后的脑血肿体积差值及脑水肿面积差值间差别无统计学意义(P>0.05)。尼莫地平组的治疗有效率显著高于常规组(P<0.05)。结论继发性脑室出血患者患侧脑血流量减少,血流速度减慢,血管阻力增加;尼莫地平能增加脑血流量和血流速度,减少血管阻力,明显提高患者的近期疗效,但对脑血肿的吸收和脑水肿的改善作用不明显。

Objective To study the cerebrovascular hemodynamic situation and observe the intervention effect of nimodipine treating the patients with secondary intraventricular hemorrhage by detecting cerebrovascular hemodynamics index （CVHI）. Methods Patients with secondary intraventricular hemorrhage were randomly divided into the therapeutic group and the control group. Detecting and comparing the CVHI, the hematoma volume and the area of edema on the CT scan in both groups before and after the treatment, then observing the therapeutic effective rates in both groups. Results In contrast with the healthy side, the changes of Vmean, Qmean, R and CP on the affected side in all patients were significant. In therapeutic group, Vmean and Qniean increased significantly at the healthy side after treatment while R and CP decreased significantly （ P 〈 0. 05）. In the control group, Qmean, R and CP changed significantly on the affected side after treatment （ P 〈 0. 05）. Compared with the control group, there were significant differences in Qmean, R and CP on the healthy side in the therapeutic group （ P 〈 0. 05）. There were no significant differences in the changes of hematoma volume and arease of edema before and after treatment between the two groups （ P 〉 0. 05 ）. The therapeutic effective rate was significantly higher in the therapeutic group than that of control group （ P 〈 0. 05 ）. Conclusion The blood flow and velocity of blood flow decrease while resistance of blood vessel increases on the affected side in patients with secondary intraventricular hemorrhage. Nimodipine can increase the blood flow and velocity of blood flow and decrease the resistance of blood vessel, so it can increase the short - term therapeutic effect in such patients. Nimodipine has no significant effect on the absorption of hematoma and the amelioration of edema.