尼莫地平2种给药途径治疗蛛网膜下腔出血后脑血管痉挛的疗效观察

Curative Effectiveness of Nimodipine Given by 2 Different Routes in the Treatment of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

目的:观察尼莫地平2种给药途径治疗蛛网膜下腔出血后脑血管痉挛的疗效。方法:68例原发性蛛网膜下腔出血患者,随机分为静脉尼莫地平组和口服尼莫地平组,通过经颅多普勒检测2种给药途径治疗脑血管痉挛后脑血流速度的变化,观察血管痉挛发生率、再出血率及死亡率,评价2种给药途径的疗效。结果:2组患者治疗后21d大脑中动脉血流速度明显改善,同治疗前比较,差异有显著性(P<0.05),治疗后21d神经功能缺损评分有显著性差异(P<0.05),且静脉尼莫地平组神经功能改善最佳,但2组无显著性差异(P>0.05);2组患者脑血管痉挛发生率、死亡率及再出血发生率明显降低,组间比较无显著性差异(P>0.05)。2组不良反应均较轻微。结论:尼莫地平治疗蛛网膜下腔出血疗效确切,口服及静脉给药疗效相当。

OBJECTIVE：To probe into the curative effectiveness of nimodipin given by 2 different routes in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage（SAH）. METHODS：68 patients with primary aneurysmal subarachnoid hemorrhage were randomized into nimodipine with intravenous administration group and nimodipine with oral administration group. Transcranial Doppler（TCD）was used to detect blood flow velocity（BFV）,incidence of cerebra1 vasospasm,rebleeding and the mortality rates in 2 groups. Curative effectiveness of nimodipine given by 2 different routes was evaluated. RESULTS：BFV was significantly improved after 21 days of treatment. Significant difference was noted before and after treatment（P0.05）. Neurologic impairment score after 21 days of treatment was significantly different from before treatment（P0.05）. The improvement of neurologic function in nimodipine with oral administration group was superior to in nimodipine with intravenous administration while there was no significant difference in 2 groups（P0.05）. Rates of cerebra1 vasospasm and rebleeding and the mortality of 2 groups were significantly decreased with mild side effect. No significant difference was noted between 2 groups（P0.05）. CONCLUSION：Nimodipine has a certain clinical effect on aneurysmal subarachnoid hemorrhage. There was no statistical significance between 2 different routes.