动脉瘤性蛛网膜下腔出血后脑血管痉挛67例临床分析

Analysis of cerebral vascular spasm after aneurysmal subarachnoid hemorrhage 67 cases

目的分析脑脊液置换联合尼莫地平防治动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CVS)的效果。方法 aSAH患者67例随机分为两组,对照组常规治疗,观察组在常规治疗基础上行脑脊液置换术。观察两组DCVS和继发性脑梗死的发生率及临床疗效及大脑中动脉平均血流速度。结果观察组总有效率明显高于对照组,大脑中动脉流速明显低于对照组(P<0.05)。结论脑脊液置换联合尼莫地平可明显降低动脉瘤性蛛网膜下腔出血患者迟发型脑血管痉挛的发生,降低大脑中动脉的平均血流速度。

Objective To analyze the effect of cerebrospinal fluid replacement combined with nimodipine in the treatment of cerebral vascular spasm（CVS） after aneurysmal subarachnoid hemorrhage（aSAH）.Methods Totally 67 cases of aSAH patients were randomly divided into two groups;The control group was given conventional treatment,and the observation group applied cerebrospinal fluid replacement treatment based on the control group.The occurrence of DCVS and secondary cerebral infarction rate and clinical curative effect of two groups were observed.Results The total efficiency in observation group was significantly higher than that of the control group,the differences were statistically significant（P 〈0.01）.After treatment,the mean velocity of middle cerebral artery in the observation group was significantly lower than that of the control group（P〈0.05）.Conclusion Cerebrospinal fluid replacement combined with nimodipine can significantly reduce the delayed cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.