尼莫地平防治动脉瘤性蛛网膜下腔出血后脑血管痉挛

Clinical Efficacy of Nimodipine in the Treatment of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

目的:观察尼莫地平对动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床疗效,为其临床应用提供依据。方法:回顾性分析动脉瘤性蛛网膜下腔出血患者临床资料166例,分为尼莫地平组和对照组,2组均给予绝对卧床、止血、脱水及对症治疗,尼莫地平组在此基础上加用尼莫地平持续泵注,观察脑血管痉挛率和病死率。结果:166例均行动脉瘤栓塞术,术后2周内尼莫地平组脑血管痉挛发生率和病死率低,与对照组比较均有统计学意义(P<0.05)。结论:尼莫地平具有显著缓解脑血管痉挛的作用,能降低动脉瘤性蛛网膜下腔出血后脑血管痉挛的发生率,且无增加再出血的风险,对动脉瘤性蛛网膜下腔出血患者早期应用尼莫地平疗效好。

OBJECTIVE：To explore the clinical efficacy of nimodipine in the treatment of cerebral vasospasm （CVS） after aneurysmal subarachnoid hemorrhage （aSAH） in order to provide reference for clinical application of nimodipine. METHODS：The clinical informations of 166 patients with aSAH were analyzed retrospectively. Patients were randomly divided into nimodipine group and control group. Both groups were given strict bed rest and other therapy including hemostasis and dewatering. Nimodipine group were additionally given continuous perfusion of nimodipine. The incidence of CVS rate and mortality were evaluated. RESULTS： All cases were applied with intravascular intervention treatment. The incidence of CVS rate and mortality of nimodipine group were lower than control group 2 weeks after operation, there were statistical significance （P0.05）. CONCLUSION： Nimodipine can significantly reduce the incidence of CVS after aSAH, decrease the risk of rehaemorrhage. It is necessary for aSAH patient to administer nimodipine at early stage.