硫酸镁治疗蛛网膜下腔出血后脑血管痉挛临床分析

Clinical analysis of magnesium sulfate treating delayed cerebral vasospasm after subarachnoid hemorrhage

目的观察硫酸镁治疗蛛网膜下腔出血患者的疗效。方法将发病3d内72例蛛网膜下腔出血患者随机分为治疗组和对照组。发病3d内开始用药,对照组用尼莫地平+氨甲环酸及降颅压、维持水电解质平衡等常规治疗;治疗组在此基础上每天加用硫酸镁25mg+NS 250ml静滴,治疗14d,2组患者3个月后进行欧洲卒中评分(ESS)、日常生活活动能力评分(ADL)和疗效评定。结果治疗组与对照组3个月后ADL评分分别为(86.2±5.72)(、73.46±4.95),2组比较差异有统计学意义(P<0.01);治疗组与对照组3个月后ESS评分分别为(89.23±3.54)(、78.22±2.16),2组比较差异有统计学意义(P<0.01);治疗组与对照组3个月后总有效率分别为81.57%、68.12%,2组比较差异有统计学意义(P<0.01)。结论硫酸镁能有效改善蛛网膜下腔出血患者日常生活活动能力和神经功能缺损。

Objiective To value the therapeutic effect of magnesium sulfate in the treatment of patients with subarachnoid hemorrhage. Methods 72 patients with subarachnoid hemorrhage within three days were randomly divided into treatment group and control group. All received medication for 14 days within three days after subarachnoid hemorrhage with nimodipine, tranexamic acid and reducing the intracranial pressure, the water and electrolyte balance of conventional treatment. Treatment group plus 25 mg of magnesium sulfate in NS 250ml intravenously. European stroke score （ESS）, ADL score （ADL） and therapeutic effect were assessed at the third month after subarachnoid hemorrhage. Results The ADL scores were（86. 2 ± 5.72）in treatment group and（73.46 ± 4.95）in control group , the ESS scores were（89.23±3. 54）in treatment group and（78. 22±2. 16）in control group. There was a significant difference between the two groups （P〈0.01）. Total efficiency was 81.57% in treatment group, 68. 12% in control group, there was a significant difference between the two groups （P〈0.01）. Conclusion Magnesium sulfate is effective in improving the activities of daily living in patients with subarachnoid hemorrhage and neurological defects.