尼莫地平和脑脊液净化对创伤性蛛网膜下腔出血的治疗研究

The treatment effects of Nimodipine and purification of cerebrospinal fluid on traumatic subarachnoid hemorrhage

目的 :探讨尼莫地平和脑脊液净化治疗创伤性蛛网膜下腔出血 (t SAH)的不同治疗作用及二者合用时的作用。方法 :经 CT证实的 112例 t SAH患者随机分为 A组 (单独尼莫地平治疗组 ) 38例 ,B组 (脑脊液净化组 ) 34例 ,C组 (尼莫地平合用脑脊液净化综合治疗组 ) 4 0例。治疗前后分别予以经颅彩色多普勒 (TCD)、CT及腰穿检查 ,观察各组治疗后出血吸收速度、临床症状改善及各组并发症发生率和预后。结果 :治疗中 ,B组的迟发性脑血管痉挛 (DCVS)、脑梗死发生率高于 A、C组 (P<0 .0 5 ) ,治疗 1周时 B、C组的脑脊液外观及压力正常或基本正常率高于 A组 (P<0 .0 5 ) ;C组并发症发生率低 ,预后优于 A、B组 (P<0 .0 5 )。结论 :尼莫地平合并脑脊液净化对 t

Objective:To evaluate the curative effects of Nimodipine or(and) purification of cerebrospinal fluid (PCSF) after traumatic subarachnoid hemorrhage (tSAH).Methods:One hundred and twelve tSAH patients who were verified by CT examination were randomly divided into three groups:group A (38 cases,Nimodipine only),group B (34 cases,PCSF only),and group C (40 cases,Nimodipine combined with PCSF).Transcranial Doppler sonography (TCD),CT and lumbar puncture test were made before and after treatment.The speed of hemorrhage absorption,improvement of clinical symptoms,incidence of complications and prognosis were observed.Results:The incidence of delayed cerebrovascular spasm in group B was significantly higher than that in group A and C ( P <0 05).The rate of normal appearance and pressure of cerebrospinal fluid in group B and C was higher than that in group A in one week following treatment ( P <0 05).Compared with group A and B,group C had the lowest incidence of complications and the best outcome.Conclusions:Nimodipine combined with PCSF have the synergistic effects on patients with tSAH.