扩容疗法应用于动脉瘤术后脑血管痉挛的效果观察

Effect of expansion therapy for cerebral vasospasm after aneurysm surgery

目的观察扩容疗法应用于动脉瘤术后脑血管痉挛的效果。方法将106例动脉瘤术后脑血管痉挛患者知情同意后分为观察组和对照组各53例。对照组给予尼莫地平治疗,观察组在此基础上给予胶体溶液静脉输注扩容治疗。对比2组经颅多普勒超声(TCD)检查结果、CT检查结果、GCS评分、血流动力学指标变化和不良反应发生率。结果观察组治疗后7d和14d的TCD值显著低于对照组(P<0.01)。2组Fisher评分差异无统计学意义(P>0.05)。观察组治疗后7d和14d的GCS评分显著高于对照组(P<0.01)。观察组治疗后、灌注后的收缩压和舒张压显著低于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论扩容疗法应用于动脉瘤术后脑血管痉挛可有效改善患者脑部供血,但会降低血压,临床治疗中应予以重视。

Objective To investigate effect of expansion therapy tor cerebral vasospasm aiter aneurysm surgery. Methods A total of 106 patients with cerebral vasospasm after aneurysm surgery were divided into observation group and control group, 53 cases in each group. Control group patients were given nimodipine; observation group patients were given colloidal solution of venous infusion for additional expansion on the basis of control group. The transcranial Doppler ultrasonography （TCD） examination results, CT results, GCS scores,hemodynamic index changes and the incidence of adverse reactions of two groups were compared. Results After the treatment of 7d and 14d,TCD value in observation group was significantly lower than that in control group （P〈0.01）. There was no statistical difference of Fisher scores in observation group （P〈0.05）. GCS score in observation group after treatment of 7d and 14d was significantly higher than that in control group （P〈0.01）. The systolic and diastolic blood pressure in observation group after treatment were significantly lower than those in control group （P〈0.05）. There was no statistical difference of adverse reactions between the two groups （P〈0.05）. Conclusion The expansion therapy for patients with cerebral vasospasm after aneurysm surgery can improve the brain blood supply,but it can lower the blood pressure,which should be paid attention to the clinical treatment.