尼莫地平术中灌洗对颅内动脉瘤开颅夹闭术患者术后预防脑血管痉挛效果的临床观察

Clinical Observation on the Preventive Effect of Nimodipine Lavaging on Cerebral Vascular Spasm in Intracranial Aneurysm Clipping Patients

目的探讨尼莫地平术中灌洗对颅内动脉瘤开颅夹闭术患者术后预防脑血管痉挛效果的影响.方法60例颅内动脉瘤行开颅夹闭手术患者随机分为3组:术中应用尼莫同20μg/m L(2 mg+生理盐水100 m L)术中灌洗组(N1组n=20)、尼莫同40μg/m L(4 mg+生理盐水100 m L)术中灌洗组(N2组n=20)、对照组生理盐水100 m L(C组n=20),分别记录术前及术后24 h脑血管痉挛指数,以及预后情况.结果术后24 h脑血管痉挛指数,N1组与N2组差异无统计学意义(P>0.05),但低于C组,差异有统计学意义(P<0.05).结论颅内动脉瘤开颅夹闭术患者给予尼莫地平术中灌洗能显著减少脑血管痉挛发生率,改善患者预后.

Objective To explore the preventive effect of nimodipine lavaging on cerebral vascular spasm in intracranial aneurysm clipping patients. Methods Sixty patients with intracranial aneurysms who underwent microsurgical clipping operation were randomly divided into 3 groups： group N1, group N2 and saline group C.Patients in group N1 were treated with nimodipine 20 μg/m L（2 mg nimodipine ＋ 100 m L saline）, patients in group N2 were given nimodipine 40 μg/m L（4 mg ＋ 100 m L saline）,patients in the saline group C（control group） were treated with 100 m L saline, cerebral vascular spasm index 24 h and prognosis were recorded before and after operation.Results The cerebral vascular spasm index had no significant difference 24 h after operation between group N1 and N2（P〉0.05）, but was lower than group C,and the difference was statistically significant（P〈0.05）. Conclusion Nimodipine intraoperative lavaging can significantly reduce the incidence of cerebrovascular spasm, and improve the prognosis of intracranial aneurysm clipping patients.