腰大池持续引流联合尼莫地平治疗动脉瘤性蛛网膜下腔出血术后脑血管痉挛的效果及对炎性因子的影响

Effect of continuous drainage of lumbar cistern combined with nimodipine on cerebral vasospasm after aneurysmal subarachnoid hemorrhage and its influences on inflammatory factors

目的探究腰大池持续引流联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(aSAH)术后脑血管痉挛的效果及对炎性因子的影响。方法选择2021年5月至2022年8月收治的80例aSAH术后脑血管痉挛患者作为研究对象,以随机数字表法将其分为对照组、观察组,每组40例。对照组接受腰椎穿刺联合尼莫地平治疗,观察组给予腰大池持续引流联合尼莫地平治疗。比较两组的治疗效果。结果治疗后,观察组的大脑中动脉平均血流速度(MCA-Vm)、大脑前动脉平均血流速度(ACA-Vm)以及大脑后动脉平均血流速度(PCA-Vm)大于对照组(P<0.05)。治疗后,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)以及C-反应蛋白(CRP)水平低于对照组(P<0.05)。治疗后,观察组的格拉斯哥昏迷量表(GCS)评分高于对照组,美国国立卫生研究院卒中量表(NIHSS)评分低于对照组(P<0.05)。结论腰大池持续引流联合尼莫地平治疗aSAH术后脑血管痉挛的效果显著,可调节患者的炎性因子水平,改善脑血流状态及昏迷情况,促进脑部神经功能恢复,值得推广。

Objective To explore the effect of continuous drainage of lumbar cistern combined with nimodipine on cerebral vasospasm after aneurysmal subarachnoid hemorrhage(aSAH)and its influences on inflammatory factors.Methods A total of 80 patients with cerebral vasospasm after aSAH who were admitted from May 2021 to August 2022 were selected as the study objects.The patients were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with lumbar puncture combined with nimodipine,and the observation group was treated with continuous drainage of lumbar cistern combined with nimodipine.The therapeutic effects of the two groups were compared.Results After treatment,the mean velocity of middle cerebral artery(MCA-Vm),mean velocity of anterior cerebral artery(ACA-Vm)and mean velocity of posterior cerebral artery(PCA-Vm)in the observation group were greater than those in the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).After treatment,the Glasgow Coma Scale(GCS)score of the observation group was higher than that of the control group,and the National Institute of Health Stroke Scale(NIHSS)score was lower than that of the control group(P<0.05).Conclusion The continuous drainage of lumbar cistern combined with nimodipine in the treatment of cerebral vasospasm after aSAH has a significant effect,it can regulate the levels of inflammatory factors,improve the state of cerebral blood flow and coma,and promote the recovery of brain nerve function,which is worth promoting.