法舒地尔联用尼莫地平预防动脉瘤性蛛网膜下腔出血后迟发性脑血管痉挛的疗效观察

目的探讨法舒地尔联用尼莫地平对预防动脉瘤性蛛网膜下腔出血后脑血管痉挛的疗效及不良反应。方法在入院后即常规给予尼莫地平静脉持续泵入的同时,将50例动脉瘤性蛛网膜下腔出血患者在作动脉瘤栓塞治疗后,均给予腰大池引流及"3H"疗法,并随机分成2组,治疗组加用盐酸法舒地尔30mg静滴,3次/d,连用14d,观察2组血管痉挛的发生情况及不良反应。结果治疗组症状性脑血管痉挛1例,无症状性脑血管痉挛3例,对照组症状性脑血管痉挛3例,无症状性脑血管痉挛10例,2组间差异有统计学意义(P<0.05)。不良反应方面2组比较差异无统计学意义。结论法舒地尔联用尼莫地平在预防动脉瘤性蛛网膜下腔出血所致血管痉挛的疗效优于单用尼莫地平,安全性亦较高。

Observation of fasudil combined of nimodipine on the prevention of delayed cerebral vasospasm in patients with aneurismal subarachnoid hemorrhage

Objective To investigate the safety and efficacy of fasudil combined of nimodipine on the prevention of delayed cerebral vasospasm in patients with aSAH(aneurismal subarachnoid hemorrhage).Methods All the 50 patients with aSAH were given coil embolization,and nimodipine continuous infusion(1~2 mg/h),then after a continuous lumbar drainage of cerebrospinal fluid and "3H" therapy,50 patients were randomly divided into two groups,the patients in therapeutic group were given hydrochloric fasudil(30 mg,tid) intravenous drip for 14 days,the incidence of cerebrovascular spasm and side effect were observed in the two groups.Results One case had symptomatic cerebral vasospasm and three cases had asymptomatic cerebral vasospasm in the therapeutic group.While in the control group,the results were 3 cases of symptomatic cerebral vasospasm and 10 cases of asymptomatic cerebral vasospasm.There was a significant difference between the two groups(P<0.05).As for adverse reaction,there was no significant difference between the two groups.Conclusion The use of fasudil combined of nimodipine on the prevention of delayed cerebral vasospasm in patients with aSAH is more effective and safety than nimodipine alone.