【摘要】 目的观察尼莫地平联合前列地尔治疗创伤性蛛网膜下腔出血(SAH)的临床疗效。方法选取2015年6月—2017年1月黄冈市英山县人民医院收治的创伤性SAH患者120例,根据治疗方法分为对照组和观察组,每组60例。在常规治疗基础上,对照组患者采用前列地尔注射液治疗,观察组患者采用尼莫地平联合前列地尔注射液治疗;两组患者均连续治疗2周。比较两组患者治疗前后格拉斯哥昏迷量表(GCS)评分、大脑中动脉(MCA)平均血流速度,症状缓解率,临床治疗有效率,治疗期间并发症及不良反应发生情况。结果治疗前两组患者GCS评分、MCA平均血流速度比较,差异无统计学意义(P>0.05);治疗后观察组患者GCS评分高于对照组,MCA平均血流速度低于对照组(P<0.05)。两组患者呕吐缓解率比较,差异无统计学意义(P>0.05);观察组患者头痛缓解率、脑膜刺激征缓解率及临床治疗有效率高于对照组(P<0.05)。治疗期间观察组患者脑血管痉挛、脑梗死发生率低于对照组(P<0.05),而两组患者病死率比较,差异无统计学意义(P>0.05)。治疗期间两组患者血压下降、颅腔积液、消化道出血发生率比较,差异无统计学意义异(P>0.05)。结论尼莫地平联合前列地尔治疗创伤性SAH的临床疗效确切,可有效改善患者神经功能及临床症状,减少脑血管痉挛、脑梗死的发生。更多还原

【Abstract】 Objective To observe the clinical effect of nimodipine combined with alprostadil on traumatic subarachnoid hemorrhage( SAH). Methods From June 2015 to July 2017,a total of 120 patients with traumatic SAH were selected in the People’ s Hospital of Yingshan County,Huanggang,and they were divided into control group and observation group according to therapeutic methods,each of 60 cases. Based on conventional treatment,patients of control group received alprostadil injection,while patients of observation group received nimodipine combined with alprostadil injection; both groups continuously treated for two weeks. GCS score and mean blood flow velocity of MCA before and after treatment, symptoms remission rate,clinical effective rate, incidence of complications and adverse reactions during the treatment were compared between the two groups. Results No statistically significant differences of GCS score or mean blood flow velocity of MCA was found between the two groups before treatment( P > 0. 05); after treatment,GCS score of observation group was statistically significantly higher than that of control group, while mean blood flow velocity of MCA of observation group was statistically significantly lower than that of control group( P < 0. 05). No statistically significant differences of vomiting remission rate was found between the two groups( P > 0. 05),while remission rates of headache and meningeal irritation sign,and clinical effective rate of observation group were statistically significantly higher than those of control group( P < 0. 05). During the treatment,incidence of cerebral vasospasm and cerebral infarction of observation group was statistically significantly lower than that of control group,respectively( P < 0. 05),while no statistically significant differences of fatality rate was found between the two groups( P > 0. 05). No statistically significant differences of incidence of blood pressure reduction, cranial cavity effusion or gastrointestinal bleeding was found between the two groups during the treatment( P > 0. 05). Conclusion Nimodipine combined with alprostadil has certain clinical effect in treating traumatic SAH,can effectively improve the neurological function,relive the clinical symptoms,reduce the risk of cerebral vasospasm and cerebral infarction.更多还原