摘要
目的分析尼莫地平在脑动脉瘤手术中的临床价值。方法选择2014年7月—2017年7月成都医学院第一附属医院神经外科治疗的脑动脉瘤夹闭术和血管内介入栓塞术患者96例作为研究对象,随机数字表法分成观察组和对照组各48例。对照组患者在常规治疗基础上行脑动脉瘤夹闭术和血管内介入栓塞术,观察组患者则在对照组基础上加用尼莫地平治疗。比较2组患者的临床治疗效果、脑血管痉挛发生率,近心端、远心端及大脑中动脉(MCA)的血流速度,脑脊液S100蛋白、血清神经元特异烯醇化酶(NSE)水平的变化,并观察不良反应。结果观察组治疗的总有效率为91.7%,显著高于对照组的75.0%(X^2=4.800,P=0.028);观察组脑血管痉挛发生率为10.4%,显著低于对照组的52.1%(X^2=19.394,P=0.000);2组患者的近心端、远心端血流速度均较治疗前显著升高,并且观察组患者升高的更为显著(t=4.363、4.013,P=0.000、0.000),而在MCA血流速度方面,2组比较差异无统计学意义(t=0.329,P=0.371);2组患者CSF中S100、血清NSE水平均较治疗前显著升高,但观察组患者的升高程度低于对照组(t=16.238、4.664,P=0.000、0.000)。2组患者在治疗的过程中均未发生较为明显的不良反应。结论尼莫地平应用于脑动脉瘤手术治疗中能够获得良好的临床效果,显著降低患者的脑血管痉挛发生率,改善患者的近心端、远心端血流速度,抑制CSF中S100、血清NSE水平的异常升高,具有重要的临床应用价值。
Objective To analyze and investigate the clinical value of nimodipine in surgical treatment of intracranial aneurysms. Methods Ninety-six cases of patients undergoing intraeranial aneurysm clipping surgery were selected, which were treated in hospital from July 2014 to July 2017, and they were divided into the observation group（48 cases ）and control group （48 eases）. The patients of control group were treated with routine basal therapy and intracranial aneurysm clipping surgery and endovascular embolization. Based on control group, the patients of observation group were treated with nimodipine. Observe and compare the clinical effects, the occurrence of cerebral vasospasm, adverse reactions and the changes of blood flow velocity of proximal and distal middle cerebral artery（MCA） , cerebrospinal fluid S100 protein, serum neuron specific enolase （NSE） levels of two groups. Results After the appropriate treatment,the patients of the observation group got a total effective rate of 91.7% ,which was significantly better than the 75.0% of the control group（ χ^2 = 4. 800 ,P = 0. 028 ） ; The patients of the observation group got the incidence of cerebral vasospasm of 10.4% ,which was significantly lower than the 52.1% of the control group（ χ^2 = 19. 394 ,P = 0. 000） ; The blood flow velocity of proximal and distal MCA in the two groups were all significantly increased than before treatment, and the patients of the observation group got more significant improvement （ t = 4. 363, t = 4.013 ; P = 0.000, P = 0.000）, but there was no statistically significant difference in blood flow velocity of MCA between two groups （ t = 0. 329 ; P = 0. 371 ） ; The CSF S100, NSE levels of the two groups were all significantly increased than before, but the degree of elevation in the observation group was lower than that in the control group（ t = 16. 238, t = 4. 664; P = 0. 000, P = 0. 000） ; There were no obvious adverse reactions occulted during the treatment in both two groups. Conclusion Nimodipine in the treatment of patients with intraeranial aneurysm surgery can achieve good clinical results, significantly reduce the incidence of cerebral vasospasm, improve the blood flow velocity of proximal and distal MCA, inhibit the abnormal rise of CSF SIO0, NSE levels, which makes it have an important clinical value.
出处
《疑难病杂志》
CAS
2018年第1期42-45,共4页
Chinese Journal of Difficult and Complicated Cases
