高压氧联合尼莫地平在接受颅内动脉瘤夹闭术患者中的效果

Application Effect of Hyperbaric Oxygen Combined with Nimodipine in Patients Undergoing Intracranial Aneurysm Clipping

目的 探讨颅内动脉瘤(IA)夹闭术患者术后接受高氧与尼莫地平治疗的效果。方法 选取2018年1月至2023年1月在漯河市源汇区人民医院接受IA夹闭术的90例患者作为研究对象,采用随机数字表法分为观察组(45例)和对照组(45例)。术后对照组接受尼莫地平治疗,观察组在对照组基础上接受高压氧治疗。比较两组患者不同时点脑血流动力学指标、神经功能损伤情况、脑血管痉挛(CVS)发生情况、预后、生活质量及日常生活能力。结果 治疗后第14天,观察组大脑中动脉平均血流速度(MFV)、收缩期最大峰值流速(SPV)均高于对照组(P<0.05),而血管阻力指数(RI)及搏动指数(PI)低于对照组(P<0.05),CVS发生率低于对照组(P<0.05),简明健康状况调查表(SF-36)评分及日常生活能力评定量表(ADL)评分高于对照组(P<0.05),格拉斯哥结局量表(GOS)预后情况优于对照组(P<0.05);治疗后第7、14天,观察组美国国立卫生研究院卒中量表(NIHSS)评分低于对照组(P<0.05)。结论 高压氧联合尼莫地平可改善IA夹闭术患者术后脑血流及神经功能,并降低脑血管痉挛发生率,改善患者预后,提高生活质量及日常生活能力。

Objective To explore the effect of postoperative treatment with hyperoxia and nimodipine in patients with intracranial aneurysm(IA)clipping.Methods A total of 90 patients who underwent IA clipping in Luohe Yuanhui District People’s Hospital from January 2018 to January 2023 were selected as the research objects.The selected objects were randomly divided into observation group(45 cases)and control group(45 cases).After operation,the control group was treated with nimodipine,and the observation group was treated with hyperbaric oxygen on the basis of the control group.The indexes of cerebral hemodynamics,neurological impairment the occurrence,prognosis,quality of life,activities of daily living andcerebral vasospasm(CVS)were compared between the two groups.Results On the 14th day after treatment,The mean flow velocity(MFV)and maximum peak systolic velocity(SPV)of middle cerebral artery in the observation group were higher than those in the control group(P<0.05),while the vascular resistance index(RI)and pulsatility index(PI)were lower than those in the control group(P<0.05).At the same time,the incidence of CVS was lower than those in the control group(P<0.05).36-item short form survey(SF-36)score and activity of daily living rating scale(ADL)score were higher than that of the control group(P<0.05),and the prognosis of Glasgow outcome scale(GOS)was better than that of the control group(P<0.05).On the 7th and 14th days after treatment,the score of National Institutes of Health stroke scale(NIHSS)in the observation group was lower than that of the control group(P<0.05).Conclusion Hyperbaric oxygen combined with nimodipine can improve postoperative cerebral blood flow and neurological function with IA clipping,reduce the incidence of cerebral vasospasm,improve the prognosis,and improve the quality of life and ability of daily living.