方明

[摘要]目的 探讨尼莫地平治疗自发性蛛网膜下腔出血致脑血管痉挛的临床效果。方法 选取我院2016年1月～2017年1月收治的自发性蛛网膜下腔出血致脑血管痉挛患者68例，将其随机分为对照组、观察组，每组34例。对照组患者给予常规治疗，观察组在常规治疗基础上加用尼莫地平治疗。比较两组患者的脑脊液恢复正常时间、头痛持续时间、血肿量、住院时间，大脑中动脉流速、炎性因子水平、GCS评分以及再出血率。结果 观察组患者的脑脊液恢复正常时间、头痛持续时间、住院时间短于对照组，血肿量少于对照组（P<0.05），观察组患者的大脑中动脉流速、炎性因子水平、GCS评分改善程度均比对照组大（P<0.05），再出血率显著低于对照组（P<0.05）。结论 尼莫地平具有较好的治疗自发性蛛网膜下腔出血致脑血管痉挛的效果，适合在临床推广应用。

[关键词]自发性蛛网膜下腔出血；脑血管痉挛；尼莫地平

[中图分类号] R743.9 [文献标识码] A [文章编号] 1674-4721（2017）03（c）-0113-03

[Abstract]Objective To investigate the clinical effect of Nimodipine treating cerebral vasospasm caused by spontaneous subarachnoid hemorrhage.Methods Sixty-eight patients with cerebral vasospasm caused by spontaneous subarachnoid hemorrhage treated by our hosopital from January 2016 to January 2017 were selected and randomly divided into control group （n=34） and observation group （n=34）.The patients in the control group were treated with conventional therapy.The observation group was treated with Nimodipine on the basis of conventional therapy.The time of cerebrospinal fluid returning to normal，headache duration time，hematoma volume，hospitalization time，middle cerebral artery velocity，inflammatory factor level，GCS score and resuscitation rate were compared between the two groups.Results The time of cerebrospinal fluid returning to normal，headache duration time，hospital stay were shorter than those of control group and hematoma volume of cerebrospinal fluid in observation group was less than that in the control group （P<0.05）.The the improvement of middle cerebral artery velocity，and level of inflammatory factor were larger than those of the control group and the rate of rebleeding in observation group was lower than that of control group （P<0.05）.Conclusion Nimodipine has a good effect on the treatment of cerebral vasospasm caused by spontaneous subarachnoid hemorrhage，and it is suitable for clinicalpromotion and application.

[Key words]Spontaneous subarachnoid hemorrhage；Cerebral vasospasm；Nimodipine

自發性蛛网膜下腔出血是常见的神经内科疾病[1]，属于出血性脑血管疾病，脑血管痉挛是自发性蛛网膜下腔出血后发生率较高的并发症，可严重降低局部脑血流量，会造成脑组织缺血，损害患者的神经功能[2]，进而导致患者残疾或死亡。临床上常使用介入及手术等方法进行治疗，运用引流脑脊液、清除颅内积血以及栓塞或夹闭脑内动脉瘤等手段终止自发性蛛网膜下腔出血患者的颅内出血情况，但少数患者还会继发脑血管痉挛，加重病情，危及患者的生命安全。尽早为患者进行治疗能够挽救患者的生命，改善预后和生活质量，因此寻找更加有效的治疗方式极为重要。本文旨在探讨尼莫地平治疗自发性蛛网膜下腔出血致脑血管痉挛的临床效果，现报道如下。……