尼莫地平灌注联合脑脊液置换术治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的疗效分析

Cerebrospinal fluid replacement combined with nimodipine in treatment of Aneurysmal Subarachnoid Hemorrhage cerebral angiospasm after curative effect analysis

目的探讨脑脊液置换术联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CVS)的临床疗效。方法回顾性分析2009年12月～2011年12月我院共收治的aSAH后CVS 110例患者的临床资料,将其随机分为2组,每组各55例,对照组患者给予常规治疗,观察组患者在对照组基础上给予脑脊液置换术联合尼莫地平进行治疗,比较两组患者的临床疗效。结果治疗1个月后,观察组患者显效率、有效率、无效率及总有效率之间差异均具有统计学意义(P<0.05);观察组患者GOS评分优于对照组患者,差异有统计学意义(P<0.05);治疗后两组间患者大脑中动脉流速比较差异有统计学意义(P<0.05)。结论脑脊液置换术联合尼莫地平治疗aSAH后CVS患者疗效确切,可迅速改善症状,且其对脑血管具有高度的选择性,不影响患者的系统血压,值得临床广泛推广和应用。

Objective To investigate the clinical efficacy of the cerebrospinal fluid replacement and nimodipine in the treatment of aneurysmal subarachnoid hemorrhage vascular spasm.Methods A retrospective analysis of hospital in December 2009 to December 2011 were treated with aneurysmal subarachnoid hemorrhage cerebral vascular spasm clinical data of 110 patients will be randomly divided into two groups,each group of 55 cases control group patients received conventional therapy,the observation group were given in the control group on the basis of cerebrospinal fluid replacement and nimodipine treatment,clinical outcomes of two groups were compared.Results after 1 month of treatment,observation group were patients with significant efficiency,efficiency,efficiency and total efficiency between the differences were statistically significant（P＆lt;0.05）;The patients GOS scores than the control group patients,the difference was significant（P＆lt;0.05）;after treatment between the two groups in patients with middle cerebral artery velocity difference was statistically significant（P＆lt;0.05）.Conclusion Exchange of cerebrospinal fluid and nimodipine efficacy of the treatment of aneurysmal subarachnoid hemorrhage,cerebral vascular spasm exact,can rapidly improve the symptoms,and cerebral blood vessels are highly selective,and does not affect the patient’s systemic blood pressure,is worthy of clinical widely promoted and applied.