尼莫地平防治蛛网膜下腔出血后迟发性脑血管痉挛

Nimodipine prevention and treatment of delayed cerebrovascular spasma after subarachnoid hemorrhage

目的：观察尼莫地平注射液防治蛛网膜下腔出血（ＳＡＨ）后迟发性脑血管痉挛（ＤＣＶＳ）的疗效。方法：将６０例ＳＡＨ病人随机分为尼莫地平组（男性２０例，女性１０例，年龄５４±ｓ６ａ）和对照组（男性２１例，女性９例，年龄５５±５ａ）各３０例。２组均于发病７２ｈ内接受治疗，对照组用脱水、止血等常规疗法，尼莫地平组在常规疗法基础上加用尼莫地平注射液５０ｍＬ（含１０ｍｇ），静脉滴注，ｑｄ×１４ｄ。结果：尼莫地平组ＤＣＶＳ发生率和ＳＡＨ死亡率明显低于对照组（Ｐ＜０．０５）；再出血发生率２组无明显差异（Ｐ＞０．０５）。结论：尼莫地平注射液预防ＳＡＨ后ＤＣＶＳ疗效确切，且无增加再出血的危险。

AIM: To observe the efficacy of prevention and treatment of nimodipine injection for delayed cerebrovascular spasma (DCVS) after subarachnoid hemorrhage (SAH). METHODS: Sixty patients with SAH were randomly divided into therapy group (M 20, F 10, age 54±s 6 a) and control group (M 21, F 9, age 55±5 a). All patients accepted therapy before 72 h after the onset of the attack. The patients of control group accepted conventional therapy (dehydration, hemostasis), therapy group accepted conventional therapy and nimodipine injection 10 mg in 50 mL, iv drip, qd×14 d. RESULTS: The morbidity of DCVS and mortality of SAH in the therapy group were obviously lower than that of control group (P<0.05); There was no statistically difference between the morbidity of rehemorrhage of the two groups (P>0.05). CONCLUSION: Nimodipine injection prevents DCVS following SAH. There is no danger of rehemorrhage.