马来酸桂哌齐特治疗外伤性蛛网膜下腔出血的疗效评价

Therapeutic Efficacy of Cinepazide Maleate for Traumatic Subarachnoid Hemorrhage

目的:评价马来酸桂哌齐特与硫酸镁联合应用治疗外伤性蛛网膜下腔出血(tSAH)的疗效。方法:160例tSAH患者随机分为对照组和治疗组Ⅰ、Ⅱ、Ⅲ,各40例。对照组给予止血、脱水、激素及促神经功能恢复药等常规治疗;除常规治疗外,治疗组Ⅰ给予马来酸桂哌齐特、治疗组Ⅱ给予硫酸镁、治疗组Ⅲ联合应用马来酸桂哌齐特和硫酸镁,均12h1次,连用14d。分别于入院时及治疗后3、7、14d行经颅多普勒(TCD)检查,观察脑血管痉挛(CVS)的发生情况及预后。结果:在CVS发生、大脑中动脉血流速率的变化、治疗后3个月及6个月的预后方面,治疗组Ⅲ与对照组、治疗组Ⅰ、治疗组Ⅱ比较差异均有统计学意义(P<0.01)。结论:马来酸桂哌齐特与硫酸镁联合应用不仅能降低CVS的发生率,而且能减轻CVS的严重程度,明显改善患者的预后。

OBJECTIVE： To evaluate the clinical efficacy of cinepazide maleate in combination with magnesium sulfate for traumatic subarachnoid hemorrhage. METHODS： A total of 160 patients with traumatic subarachnoid hemorrhage were randomly assigned to 4 groups： Control group （n = 40） received conventional therapy alone （hemostasis, dehydration, hormone and drugs promoting recovery of nervous function; Group Ⅰ （Control group, n = 40） received cinepazide maleate plus conventional therapy; Group Ⅱ （n = 40） received magnesium sulfate plus conventional therapy, and Group Ⅲ （n = 40） received cinepazide maleate in combination with magnesium sulfate in additional to the conventional therapy. All the drugs were given in every 12 h for 14 consecutive days. Transcranial Doppler （TCD） examination was scheduled at 0, 3, 7, 14 days after admission to observe the incidences of cerebral angiospasm （CVS） and patients＇ prognosis. RESULTS： There were significant differences between Group Ⅲ and the other 3 groups （Control group, Group Ⅰ and Group Ⅱ ） in the incidence of CVS, the change of the blood flow rate of the middle cerebral artery and patients＇ prognosis at 3 and 6 months respectively（P〈0.01） . CON- CLUSION： The combined application of cinepazide maleate and magnesium sulfate not only decreases the incidence of CVS, but also attenuates the severity of CVS and markedly improves patients＇ prognosis.