尼莫地平治疗创伤性蛛网膜下腔出血的临床分析

【目的】观察尼莫地平治疗创伤性蛛网膜下腔出血（〉SAH）的，1盘床疗效。【方法】将86例t-SAH患者随机分为两组，每组43例。对照组采用快速静点甘露醇脱水降颅内压和营养神经等治疗；治疗组在对照组基础上于入院后立即给予静脉泵入尼莫地平注射液，治疗两周后改为尼莫地平片口服，疗程一周。观察创伤后和治疗后格拉斯哥昏迷评分指数（GCS），颅内压变化，检测伤后和治疗后大脑中动脉（MCA）收缩期峰值流速（VP）变化，并于治疗后三个月随访记录格拉斯哥预后评分（GOS）。【结果】治疗组脑血管痉挛（CVS）发生率低于对照组，且差异有显著性（P〈0．05），两组不同时间的VP值、GCS和颅内压差异有显著性（P〈0．05），随访三个月后治疗组预后不良发生率明显低于对照组（P〈0．05）。【结论】尼莫地平能够有效降低GCS、VP，对t-sAH有较好的疗效。

Clinical Analysis of Nimodipine for the Treatment of Traumatic Subarachnoid Hemorrhage

Objective]To observe the clinical efficacy of nimodipine for the treatment of traumatic subarachnoid hem orrhage（t-SAH）. Methods] Totally 86 patients with t-SAH were randomly divided into two groups with 43 cases in each group. Control group was given rapid intravenous infusion of mannitol for dehydration and reducing intracranial pres sure and neurotrophy. On the basis of the treatment of control group, the treatment group was given venous pump of ni- modipine injection immediately after admission, and then replaced with oral nimodipine after 2 weeks for a week. Glasgow coma score（GCS） and intracranial pressure were observed after trauma and treatment. Peak systolic velocity（VP） of mid- dle cerebral artery（MCA） was measured after trauma and treatment. Glasgow outcome score（GOS） was followed up and recorded 3 months after treatment. ResultslThe incidence of cerebral vasospasm（CVS） in treatment group was lower than that in control group, and there was significant difference（ P 〈0.05）. There were significant differences in VP, GCS and intracranial pressure at different time between two groups（ P 〈0.05）. After 3 months of follow up, the incidence of poor prognosis in treatment group was obviously lower than that in control group（ P 〈0.05）. Conclusion] Ni- modipine can effectively reduce GCS and VP, and has better efficacy for the treatment of t-SAH.