尼莫地平治疗蛛网膜下腔出血的临床疗效分析

The Mechanism and Clinical Efficacy of Nimodipine in the Treatment of Subarachnoid Hemorrhage

目的探究尼莫地平治疗蛛网膜下腔出血的临床疗效.方法选取保山市人民医院于2011年4月至2013年4月收治的102例蛛网膜下腔出血患者,随机分为对照组和治疗组,对照组采用常规止血治疗,治疗组在此基础上注射尼莫地平治疗.利用颅内压监护仪对2组患者进行1、4、7、10 d的连续监测并记录其值;治疗4周后通过CT复查头颅,判定手术前后患者恢复及并发症情况;术后3个月随访进行GOS分值记录.结果通过连续的颅压监测,发现治疗组在第7天与第10天时颅压值明显低于对照组(P<0.05);在患者的治愈情况上,治疗组的有效率为92.16%,明显高于对照组的80.39%(P<0.01);治疗组的再出血、脑血管痉挛、脑积水发生率较对照组低,且死亡率明显减少(P<0.05);术后随访发现治疗组有33.33%恢复良好,而对照组只有17.65%,P<0.05.结论在蛛网膜下腔出血的早期治疗中加入尼莫地平静脉注射及连续口服,能获得良好的治疗效果,因此适宜临床应用.

Objective To explore the mechanism and clinical efficacy,we applied a drug of nimodipine to treat the patients with subarachnoid hemorrhage.Methods We chose 102 cases patients who had the subarachnoid hemorrhage in our hospital from April 2011 to April 2013.All patients were divided into the control group and the treatment group in accordance with the equitable and randomly selected principles.The patients in the control group received the usual surgery,while patients in the treatment group were treated by nimodipine.The two indexes of groups patients were recorded,including the pressure within the skull,complications and the mortality rate by intracranial pressure detector or CT.The scores of GOS were also recorded after 3 months follow-up.Results By intracranial pressure detector,we found that the pressure within the skull of treatment group was lower than control group in the seventh and tenth days （P＜0.05） ; in the case of patient＇s cure,treatment group＇s effective rate was 92.16％,which was significantly higher than 80.39％ of control group （P＜0.01） ; The rebleeding,cerebral vasospasm,hydrocephalus of treatment group were lower than the control group,and the mortality rate was significantly reduced （P＜0.05） ; After surgery we found that 33.33％ of the treatment group recovered well,while the control group only 17.65％,P＜0.05; it showed that the treatment group still had some efficacy.Conclusion Injecting nimodipine has good effect in the early treatment of subarachnoid hemorrhage,so it has a high clinical application value.