早期应用尼莫地平治疗脑出血的临床疗效报告

目的 :探讨用尼莫地平降低血压 ,提升颅内压 ,从而控制高血压脑内出血。方法 :将 6 5例脑出血病人随机分为两组 ,治疗组 35例 ,用尼莫地平 10mg静滴 ;对照组 30例 ,用 2 0 %甘露唇 2 5 0ml,每日 2次或 3次 ,两组治疗 7天 ,2周内复查头颅CT。结果 :治疗组的血压平均由 179/ 10 4降至 15 1/ 91mmHg ,对照组由 181/ 10 8降为 180 /10 3mmHg ,两组比较有统计学意义 (P <0 0 1) ,对照组血肿扩大 18例 (6 0 % ) ,治疗组为 3例 (8 5 7% ) ,两组比较有统计学意义 (P <0 0 1)。对照组死亡 7例 ,因脑疝 6例 ,并发症死亡 1例 ;治疗组因肺部感染和消化道出血死亡 1例。结论 :尼莫地平可扩张血管 ,降低血压和提高颅内压 ,使破损血管壁的跨壁压力梯度下降 ,有止血和防止再出血的功能 ,可作为首选抢救药物之一 ,发病早期患者无脑疝或因颅高压引起的昏迷 ,就不要用甘露醇类的降低颅内压的药物 ,以免血肿扩大

A clinical report of cerebral hemorrhage treatment with nimodipine intravenous infusion in early stage

Objective:To investigatie the clinical application of nimodipine intravenous drop,by its lowering blood pressure,ascending intracranial pressure affect and control hypertensive intracerebral hemorrhage.Methods:Intracerebral hemorrhage patient 65 cases,by randomized selection in two groups:nimodipine group(or treatment group,TG):35cases,with nimodipine 10mg IV drip,QD or BID;mannitol group(or control group,CG):30 cases,20% mannitel 250ml IV q12h or q8h,both groups 7 days.In two weeks,repeat CT cranial examination.Results:TG Bp descending from 179/104 mmHg to 151/91 mmHg.CG,181/108 mmHg to 180/103 mmHg,deference significant between the 2 groups (P<0 01);In the CG blood clot scale augmented in 18 cases (60%),while in the TG,only 3 cases(8.57%),difference significant (P<0 01).In CG,7 patients died,by the cause of cerebral hernia 6 cases ,another complication 1 case;In TG,only 1case died due to pulmonary infection and digestive tract bleeding.Conclusion:nimodipine can dilate blood vessel,lower Bp,and ascend intracranial pressure,diminish the trans wall pressure gradient of injured blood vessel,obtain haemostatic and prevent rehemorrhagic effect.May be applied as emergency drug.In the early stage of attack,without coma due to intracranial hypertension or cerebral hernia,not to use drug to lower intracranial pressure is preferred,such as manitol for the avoidance of blood clot augmentation.