尼莫地平联合复方丹参液治疗蛛网膜下腔出血的临床疗效

Clinical efficacy observation of nimodipine combined with compound danshen solution in treating patients with subarachnoid hemorrhage

目的观察研究联合应用尼莫地平和复方丹参治疗蛛网膜下腔出现的临床疗效及安全性。方法选取2010年1月~2015年1月运城市盐湖区人民医院收治的急性蛛网膜下腔出血患者60例,按随机数字表法分为观察组及对照组,每组各30例,对照组患者给予降颅压、对症支持治疗、稳定酸碱电解质平衡等常规治疗,治疗组在对照组基础上加用尼莫地平联合复方丹参液治疗,记录并分析治疗前后2组患者脑脊液S100-β蛋白变化、临床疗效及并发症发生率。结果治疗5、7、14 d后观察组患者S100-β蛋白分别（0.095±0.014、0.072±0.011、0.022±0.010）μg/L,均优于对照组（1.120±0.012、0.098±0.013、0.052±0.009）μg/（P〈0.05）;治疗后观察组总有效率达90.0%,高于对照组63.3%（P〈0.05）;治疗组再出血、脑缺血、脑积水等并发症与对照组相当,两者差异无统计学意义。结论尼莫地平联合复方丹参液治疗蛛网膜下腔出血疗效肯定、确切,与常规治疗相比无明显不良反应,能显著提高患者蛛网膜下腔出血治愈率、降低患者死亡率,值得临床进一步研究和应用。

Objective To analyze clinical efficacy of nimodipine combined with compound danshen solution in treating patients with subarachnoid hemorrhage. Methods 60 patients with acute subarachnoid hemorrhage were randomly divided into observation group and control group from January2010 to January 2015,30 cases in each group. Control group was treated with reduce intracranial pressure,symptomatic and supportive treatment,stable p H and electrolyte balance and other conventional treatment,observation group was given conventional therapy basis on the use of nimodipine combined with compound danshen solution,the situation of S100-β in cerebrospinal fluid,clinical efficacy and the incidence of complications of two groups were recorded and analyzed before and after treatment. Results Treatment 5,7,14 d after S100-β protein were observed in patients（ 0. 095 ± 0. 014,0. 072± 0. 011,0. 022 ± 0. 010） μg / L,were better than control group（ 1. 120 ± 0. 012,0. 098 ± 0. 013,0. 052 ± 0. 009） μg / L（ P〈0. 05）. Treatment observation group total effective rate was 90. 0%,higher than 63. 3% of control group（ P〈0. 05）. Rebleeding,cerebral ischemia,hydrocephalus and other complications of treatment group were similar to control group,the difference was not significant. Conclusion Clinical efficacy of nimodipine combined with compound danshen solution in treating subarachnoid hemorrhage is effective,precise,which compares with conventional therapy,there is no significant adverse reactions. It can significantly improve the cure rate in patients with subarachnoid hemorrhage,reducing mortality,and it is worthy of further research and applications.