摘要
目的观察早期应用尼莫地平及联合应用腰大池引流治疗重型颅脑损伤的临床疗效。方法将96例重型颅脑损伤病例随机分为治疗组和对照组,治疗组48例,在开颅手术中即应用尼莫地平,术后在常规药物治疗基础上给予尼莫地平20mg24h微泵维持匀速静脉注射,疗程14d,后改为尼莫地平片60mg,4次/d,疗程7d,并于术后第3天开始行腰大池持续引流。对照组除未给予尼莫地平及行腰大池引流外其他治疗相同。记录两组入院后14dGCS评分及监测7d的颅内压变化,以及脑脊液恢复正常时间,行统计学分析;治疗后4个月时对两组GOS评分及硬膜下积液、脑积水、脑梗死等并发症的发生率进行比较。结果治疗组与对照组相比较,7d内颅内压下降不明显,差异无统计学意义(P>0.05);治疗组入院后14dGCS评分明显高于对照组,差异有统计学意义(P<0.05);治疗组脑脊液恢复正常时间为(6.5±2.5)d,对照组为(14.5±3.5)d,差异有统计学意义(P<0.05);治疗组迟发性出血例数略多于对照组,但两组比较差异无统计学意义(P>0.05);治疗后4个月GOS评分治疗组明显优于对照组,两组比较差异有统计学意义(P<0.01);治疗组硬膜下积液、脑积水及脑梗死发生率为4.5%,对照组为25.4%(P<0.05)。结论早期应用尼莫地平及联合应用腰大池引流治疗重型颅脑损伤有显著疗效,值得推广。
Objective To observe the therapeutic effect of nimodipine in treatment of severe cranio-cerebral trauma with subarachoid hemorrhage（SAH）.Methods 96 patients with severe cranio-cerebral injury complicated by SAH（GCS3-8） were divided randomly into two groups.In nimodipine group 20mg nimodipine was injected intravenously bymicro-pump for 14 days,then 60mg by oral administration QID×7 days.In control group patients receives the same treatment measures but no nimodipine was given.Intracranial pressure and GCS were closely observed,GOS andcomplication were measured 4 months later.Results The GCS of nimodipine group from the first 4 days after treatment was significantly higher than that of the control group（P0.05）;the intracranial pressure of the nimodipine group was slightly higher than the control group in the first 3 days,but there was no significant difference（P0.05）.the incidences of cerebral infarction and hydrocephalus in the nimodipine group were significantly less than that of control group（P0.05）,the incidence of delayed bleeding slightly more than the control group,but there was no significant difference（P0.05）.The GOS of the nimodipine group after 4 months was significantly higher than the control group（P0.01）.Conclusion Nimodipine has definitive therapeuric effect for severe cranio-cerebral trauma with SAH.
出处
《临床合理用药杂志》
2011年第11X期7-8,共2页
Chinese Journal of Clinical Rational Drug Use
关键词
颅脑损伤
尼莫地平
蛛网膜下腔出血
Craniocerebral trauma
Nimodipine
Subarachoid hemorrhage
