尼莫地平联合腰大池外引流治疗创伤性蛛网膜下腔出血疗效分析  

Effects of nimodipine combined with lumbar drainage of cerebrospinal fluid in treatment of traumatic subarachnoid hemorrhage

作　　者：吴仰宗 林元相[2] 邓志鸿[1] 范志泉[1] 

机构地区：[1]龙岩市第二医院神经外科,福建龙岩364000 [2]福建医科大学附属第一医院神经外科

出　　处：《中国校医》2017年第8期596-598,共3页Chinese Journal of School Doctor

基　　金：福建省自然科学基金资助项目(2015J01387);福建医科大学教授及学科带头人基金(JXK201301;JS15014)

摘　　要：目的探讨尼莫地平联合持续腰大池外引流在治疗创伤性蛛网膜下腔出血(t SAH)中的疗效。方法选择福建省龙岩市第二医院神经外科自2013年12月至2016年12月收治的116例t SAH患者,随机分为观察组和对照组各58例。观察组在常规药物治疗基础上,应用尼莫地平和持续腰大池外引流治疗,对照组予常规药物治疗。比较2组的昏迷评分(GCS)、头痛视觉模拟评分(VAS)、格拉斯哥预后评分(GOS)、脑积水发生率、脑梗死发生率和癫痫发生率。结果 2组经治疗14 d后,和对照组比较观察组GCS显著升高,VAS明显降低,差异有统计学意义(P<0.05)。脑梗死发生率和3个月后脑积水发生率明显降低,但差异无统计学意义(P>0.05)。GOS评分和癫痫发生率未见明显差异。结论尼莫地平联合腰大池外引流治疗创伤性蛛网膜下腔出血方法简单、疗效好、降低并发症、安全可靠,值得推广。Objective To explore the effects of nimodipine combined with the persistent lumbar drainage of cere- brospinal fluid in the treatment of traumatic subarachnoid hemorrhage （tSAH）. Methods A total of 116 patients with tSAH in the second hospital of Longyan City from December 2013 to December 2016 were randomly divided into an obser- vation group （n= 58） and a control group （n=58）. The patients in the observation group were treated with nimodipine and lumbar drainage of cerebrospinal fluid, and the patients in the control group received the routine treatment, and then the GCS scores, VAS scores, GOS scores, VAS scores, hydrocephalus incidence, infarction incidence and epilepsy incidence were observed and compared between the two groups. Results Fourteen days after the treatment, the GCS scores and VAS scores in the observation group were better than those in the control group, and the difference were statistically signifi- cant （P〈O.05）. Three months after the treatment, the infarction incidence and hydrocephalus incidence in the observation group were lower than those in the control group, but the difference was not statistically significant （P〉0.05）. The GOS scores and epilepsy incidence were not significantly different between the two groups . Conclusion The therapy of ni- modipine combined with the persistent lumbar drainage of cerebrospinal fluid in the treatment of traumatic subarachnoid hemorrhage is safe, simple, and effective, and in addition, it has lower complications, so it is worthy of promotion.

关 键 词：蛛网膜下腔出血 创伤性/治疗 尼莫地平/治疗应用 脑脊髓液分流术/方法 腰椎 脊椎穿刺/治疗应用 

分 类 号：R605[医药卫生—外科学]