芳香开窍药嗅吸剂在治疗创伤性蛛网膜下腔出血脑血管痉挛中的应用研究

目的：观察由芳香开窍药组成的嗅吸剂治疗创伤所引起的蛛网膜下腔出血后脑血管痉挛的疗效。方法：22例经颅多普勒（TCD）检查显示大脑中动脉（MCA）≥120cm.s-1颅脑外伤致外伤性蛛网膜下腔出血住院成人患者随机分为治疗组：12例,对照组：10例,全部患者入院后均给予常规治疗,治疗组入院第2d起给予芳香开窍嗅吸剂雾化吸入,两组分别于入院后第2d、第3d、第5d、第7d、第9d、第11d行颅多普勒TCD检查脑血流变化。结果：治疗组经鼻腔给药途径吸入芳香开窍药治疗脑血管痉挛后脑血流速度6d后明显改善,同对照组比较,差异有显著性（P〈0.05）。结论：经鼻雾化吸入芳香开窍药可以达到缓解颅脑损伤合并蛛网膜下腔出血时脑血管痉挛的效果,其机制可能是药物除可以通过鼻黏膜及肺部丰富的毛细血管吸收外,还可以直接通过鼻黏膜-脑脊液途径进入脑脊液,突破或绕过血脑屏障,将药物靶向脑部达到缓解颅脑损伤合并蛛网膜下腔出血时脑血管痉挛的效果。

Study on Aromatic Resuscitation Drug Sniffing Agent in Treatment of Cerebral Vasospasm after Traumatic Subarachnoid Hemorrhage

Objective：To observe the effect of aromatic resuscitation drug sniffing in the treatment of traumatic cerebral Vasospasm caused by subarachnoid hemorrhage. Method ：22 cases by cranial more general Doppler （TCD） check displayed brain in the artery （MCA） I〉 120 cm . s^-1 head trauma induced subarachnoid hemorrhage adult patients were randomly di- vided into treatment groups with 12 cases, and control group with 10 cases. All patients were give general treatment. The treatment group was given aromatic resuscitation olfactory sucking agent atomization inhalation from the 2nd day after admit- ting. Two Groups were respectively checked through Doppler TCD check for blood flow changes on 2nd,3rd,5th,7th,9th, and 1 l th day. Results：By the nasal route of inhalation of aromatic resuscitation,the treatment group＇s cerebral vasospasm following cerebral blood flow velocity had marked improvement after 5 days treatment, in comparison with control group, differences were significant （ P 〈 0. 05 ）. Conclusions ： Nasal atomization inhalation aromatic resuscitation drug can relieve vascular spasm of head injury combined with subarachnoid hemorrhage. Its mechanism may be entering the cerebrospinal fluid through nasal mucosa -cerebrospinal fluid way besides the absorption of nasal mucosa and rich capillaries in lung,in order to breakthrough or bypass blood brain barrier, so that drugs can target to brain and achieve the treatment effect.