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目的 :研究尼莫通对外伤性蛛网膜下腔出血 (tSAH)脑血管痉挛 (CVS)的治疗效果。方法 :将 46例tSAH患者随机分为常规治疗组和尼莫通治疗组 ,通过经颅多普勒超声诊断仪 (TCD)观察治疗前、治疗后 ( 3d、5d、10d)脑血管血流动力学变化以判断尼莫通对tSAH后CVS的治疗作用及临床症状的改善情况。结果 :治疗组临床症状、体征改善有效率 78 2 6% ,对照组 3 0 43 %。治疗组与对照组治疗前TCD检查MCA均轻度升高。治疗组第 3天峰值明显增高 ,到第 5天开始下降 ,第 10天接近正常。对照组第 3天到第 10天峰值远比治疗组高。结论 :尼莫通能明显缓解tSAH后早期CVS ,改善临床症状。TCD对于tSAH后CVS的判断具有操作容易、安全、无创伤、迅速方便、反映客观 ,对外伤性蛛网膜下腔出血的早期诊断、鉴别诊断有实用价值 ,能为临床治疗及预后提供指导依据。
Objective: To investigate the therapeutic effect of nimotong on cerebral vasospasm (CVS) after traumatic subarachnoid hemorrhage (tSAH). Methods: Forty-six patients with tSAH were randomly divided into routine treatment group and nimotop group, and the changes of cerebral blood flow dynamics before and after treatment (3d, 5d, 10d) were observed by transcranial Doppler ultrasonography (TCD) Changes in learning to determine the effect of nimotop on CVS after tSAH and the improvement of clinical symptoms. Results: The effective rate of clinical symptom and symptom improvement was 78 26% in the treatment group and 3043% in the control group. Treatment group and control group before treatment TCD MCA were mildly elevated. The peak value of the third day of treatment group was significantly increased, began to decline on the 5th day, the 10th day close to normal. The peak value of the third day to the tenth day of the control group was much higher than that of the treatment group. Conclusion: Nimotopone can obviously relieve early CVS after tSAH and improve clinical symptoms. TCD for the determination of CVS after tSAH easy to operate, safe, noninvasive, rapid and convenient, reflecting the objective, early diagnosis of traumatic subarachnoid hemorrhage, differential diagnosis of practical value, can provide guidance for clinical treatment and prognosis.