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目的观察小脑顶核刺激联合丁咯地尔治疗老年椎-基底动脉供血不足(VBI)的临床疗效和安全性。方法选择老年VBI急性期患者80例,随机分为综合治疗组44例,药物组36例,均每日给予盐酸丁咯地尔200mg静脉滴注,综合组加用小脑顶核刺激,治疗前后经颅多普勒超声(TCD)检测2组患者双侧椎动脉、大脑后动脉及其底动脉(VA、PCA、)的平均血流速度(Vm)。BA结果与治疗前比较,综合治疗组5~7天时,临床症状出现明显改善(P<0.05);治疗4周后,组患者双侧VA、PCA、的Vm均增加,综合组优于药物组(P<0.05)。2BA结论小脑顶核电刺激联合丁咯地尔治疗可显著增加脑血流量,促进脑供血不足区域的血流灌注,改善脑细胞功能,有助于老年VBI患者症状的早期改善,有良好的临床疗效和安全性。
Objective To observe the clinical efficacy and safety of cerebellar fastigial nucleus stimulation and buflomedil in the treatment of vertebrobasilar insufficiency (VBI) in elderly patients. Methods Eighty elderly patients with acute VBI were randomly divided into treatment group (n = 44) and drug group (n = 36). All patients were given buflomedil hydrochloride 200mg intravenously every day. The combined group was treated with cerebellar fastigial nucleus stimulation before and after treatment The mean blood flow velocity (Vm) of the bilateral vertebral arteries, the posterior cerebral artery and the basilar artery (VA, PCA,) in the two groups was measured by CTA using TCD. BA results compared with before treatment, the comprehensive treatment group 5 to 7 days, the clinical symptoms showed significant improvement (P <0.05); 4 weeks after treatment, bilateral VA, PCA, Vm were increased in the comprehensive group was better than the drug group (P <0.05). 2BA Conclusion Cerebellar fastigial electrical stimulation combined with buflomedil treatment can significantly increase cerebral blood flow, promote blood perfusion in areas of insufficient cerebral blood supply, improve brain cell function, contribute to the early symptoms of elderly VBI patients with good clinical efficacy And safety.