尼莫地平不同给药途径治疗蛛网膜下腔出血后脑血管痉挛

脑血管痉挛(CVS)一直被认为是蛛网膜下腔出血(SAH)后严重的并发症.本文回顾了尼莫地平不同给药途径治疗SAH后CVS的研究进展.尼莫地平作为第二代双氢吡啶类钙离子拮抗剂能有效降低SAH后的全脑梗塞和不良预后.尼莫地平局部应用可增加药物浓度,减少全身应用引起的副作用,有效扩张血管管腔,改善术中CVS,减少手术后症状性CVS的发生,改善动脉瘤SAH患者的预后.尼莫地平口服、静脉应用对于治疗SAH后CVS已取得肯定的效果,更加深入研究其局部应用治疗SAH后CVS的作用及其作用机理,可进一步提高尼莫地平的疗效.

Different administrations of nimodipine for the treatment of cerebral vasospasm after subarachnoid hemorrhage

Cerebral vasospasm (CVS) has long been considered as the most dreadful complication after subarachnoid hemorrhage (SAH). This paper reviewed the domestic and overseas research progress on the different administrations of nimodipine for the treatment of CVS after SAH. These studies have demonstrated that nimodipine as the second generation dihydropyridine calcium channel antagonist could decrease the incidence of overall cerebral infarction and poor outcomes after SAH. The topical administration of nimodipine can increase the concentration, decrease the side effect of systemic administration, dilate the vessel effectively, reverse intraoperative CVS, decrease the probability of postoperative symptomatic vasospasm and improve the outcome of patients after SAH. The oral and intravenous administration of nimodipine for the treatment of CVS after SAH has achieved definite effect. The further study on the effect and mechanism of topical administration of nimodipine for the treatment of CVS after SAH can improve curative effect.