尼莫地平治疗蛛网膜下腔出血后脑血管痉挛

Clinical Observation of Nimodipine on Cerebro-vascular Spasm Followed by Subarachnoid Hemorrhage

目的 :观察尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床疗效。方法 :61例蛛网膜下腔出血合并脑血管痉挛患者分为治疗组 43例 ,给予尼莫地平 10mg·d 1 ,静脉滴注 ,qd ;对照组 18例 ,给予山莨菪碱 10mg ,po ,tid。疗程均为 14d。两组同时给予降颅压、抗纤溶及对症支持治疗等。观察治疗前后临床症状或体征改善情况 ,并在治疗期间监测大脑中动脉 (MCA)血流速度。结果 :与对照组比较 ,尼莫地平治疗组各临床症状和体征改善率明显增高 ;相应的经颅多普勒超声 (TCD)监测发现用药后 12h两者即出现差异显著性 ,即治疗组改善明显优于对照组 ,此疗效持续到治疗 2周。结论 :静脉滴注尼莫地平较口服山莨菪碱治疗蛛网膜下腔出血后脑血管痉挛更为有效。

Objective:To observe the clinical effects and lab changes of nimodipine on vascular spasm followed by subarachnoid hemorrhage. Methods:61 cases of cerebro-vascular spasm(CVS) followed by subarachnoid hemorrhage were divided into two groups: 43 cases in the treatment group were given nimodipine 10 mg·d -1 by intravenous drip, 18 cases in the control group were given anisodamine 10 mg po, tid. The course of treatment for both groups lasted 14 days. Improvements of symptoms and signs of 43 patients were observed before and after (nimodipine) injection, and blood velocity of MCA was measured during therapy. Results:Compared with control, clinical signs and symptoms were improved notedly in nimodipine patient group; TCD observation found noted difference between the two groups 12 h after the treatment, and the difference continued in 2 weeks. Conclusion:Nimodipine injection given by vein is more effective on CVS followed by SAH than anisodamine taken orally.