依达拉奉联合尼莫地平治疗创伤性蛛网膜下腔出血

Effect of traumatic subarachnoid hemorrhage(tSAH) by edaravone combined with nimodipine

目的:探讨依达拉奉联合尼莫地平治疗创伤性蛛网膜下腔出血(tSAH)的疗效。方法:200例tSAH患者随机分为对照组(50例):给予止血、脱水、支持及对症处理等常规治疗;治疗组Ⅰ(50例):除常规治疗外,加用依达拉奉30mg+0.9%氯化钠注射液250mL,bid,共14d;治疗组Ⅱ:除常规治疗外,加用尼莫地平10mg.d-1持续静脉微量泵入,共14d;治疗组Ⅲ(50例):治疗组Ⅰ、Ⅱ的措施联合应用。入院时及入院后第3,7,14天行经颅多普勒(TCD)检查,观察蛛网膜下腔出血的并发症、脑血管痉挛(CVS)的发生情况及预后。结果:治疗组Ⅲ与对照组、治疗组Ⅰ、Ⅱ相比较,在CVS的发生、大脑中动脉血流速度的变化、3个月及6个月的预后方面差异均有显著性(P<0.05)。结论:依达拉奉联合尼莫地平应用不仅能减轻tSAH发生CVS的严重程度,且能降低CVS的发生率和明显改善患者的预后。

OBJECTIVE To investigate the therapeutic effect of traumatic subarachnoid hemorrhage（tSAH） by edaravone combined with nimodipine. METHODS The 200 tSAH patients were divided into 4 groups randomized. Control group（50 patients） just with haemostasis, anhydration and support therapy. Group Ⅰ （50 patients） with edaravone 30 mg and 0. 9% normal saline 250 mL every 12 h, continued 14 days excluded normal therapy. Group Ⅱ （50 patients） with nimodipine 10mg·d^-1 with minipump, continued 14 days. Group Ⅲ （50 patients） with edaravone 30 mg and 0. 9% normal saline 250 mL every 12 h and nimodipine 10 mg·d^-1 with minipump, continued 14 days. Investigated the complication, cerebral vessel spasm and prognosis of tSAH in 3^rd day, 7^th day and 14^th day with transcranial Doppler（TCD）. RESULTS Compared with control group, group Ⅰ and group Ⅱ , there was significant difference in development of CVS, blood flow rate of middle cerebral artery（MCA） and the prognosis after 3 months and 6 months （P〈0. 05）. CONCLUSION Edaravone eombinated with nimodipine can abate the degree and the incidence rate of CVS, and also can improve the prognosis of tSAH patients.