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目的 :评价丁咯地尔和尼莫地平对脑血管痉挛 (CVS)的疗效和血流动力学的影响。方法 :CVS病人 117例随机分成 2组 ,丁咯地尔组给丁咯地尔 150mg ,iv ,gtt ,qd× 7～ 10d后改 150mg ,po ,tid× 3wk ;尼莫地平组给尼莫地平 10mg ,iv ,gtt,qd× 7～ 10d后改 30mg ,po ,tid× 3wk ,治疗后检测血流动力学变化。结果 :对蛛网膜下腔出血所致的CVS ,尼莫地平组有效率为 94 % ,丁咯地尔组为69 % (P <0 .0 5) ;对脑血管舒、缩功能紊乱所致CVS的有效率丁咯地尔组为 93% ,尼莫地平组为 61%(P <0 .0 5)。结论 :2药对不同病因CVS效果不同 ,应根据不同病因选择不同药物 ,TCD可作为CVS治疗中判断疗效的常规检测手段。
PURPOSE: To evaluate the efficacy and hemodynamics of buflomedil and nimodipine on cerebral vasospasm (CVS). Methods: One hundred and thirteen patients with CVS were randomly divided into two groups: buflomedil 150 mg, bupivolil 150 mg, po, tid × 3 weeks after iv, gtt, qd 7 to 10 days, nimodipine 10mg, iv, gtt, qd × 7 ~ 10d after the change 30mg, po, tid × 3wk, hemodynamic changes after treatment. Results: The effective rate of CVS and nimodipine group was 69% and that of buflomedil group was 69% (P <0.05) due to subarachnoid hemorrhage; The effective rate of CVS was 93% in the buflomedil group and 61% in the nimodipine group (P <0.05). Conclusion: The two drugs have different effects on different etiologies of CVS. Different drugs should be chosen according to different etiologies. TCD can be used as a routine measure of efficacy in the treatment of CVS.