电针配合尼莫地平治疗大脑中动脉瘤夹闭术后脑血管痉挛  

Electroacupuncture combined with nimodipine in the treatment of cerebral vasospasm after clipping of middle cerebral artery aneurysm

作　　者：刘坤 黄红星[1] 罗琳[2] 

机构地区：[1]湖南省第二人民医院(湖南省脑科医院)神经外科,湖南长沙410007 [2]湖南中医药大学医学院,湖南长沙410208

出　　处：《中国实用神经疾病杂志》2017年第21期60-63,共4页Chinese Journal of Practical Nervous Diseases

基　　金：湖南省卫计委科研基金(C2015-46);湖南省教育厅优秀青年科研项目(16B196);湖南省临床重点专科建设项目(201512)

摘　　要：目的探讨电针配合尼莫地平治疗大脑中动脉瘤夹闭术后脑血管痉挛的疗效。方法回顾性分析60例经显微夹闭术处理破裂大脑中动脉瘤患者,术后TCD证实不同程度脑血管痉挛,30例术后应用尼莫地平持续泵入(甲组),连用14d;30例在尼莫地平组治疗基础上加用电针疗法(乙组),选用下关、百会及风池穴。术后3d、7d及14d评估GCS评分、脑血管痉挛程度、mRS评分等。结果术后7d和14d,乙组GCS评分明显高于甲组,脑血管痉挛为轻度比例达76.7%、93.3%;术后1个月随访,乙组mRS评分好于甲组,差异均有统计学意义(P<0.05);而术后3d,2组GCS评分及脑血管痉挛恢复程度差异无统计学意义(P>0.05)。结论尼莫地平配合电针对大脑中动脉瘤破裂所致脑血管痉挛有一定改善作用,时间越长,效果可能越明显。Objective To investigate the effect of nimodipine combined electroacupuncture on the treatment of cerebral vasospasm after the middle cerebral artery aneurysms in the brain. Methods Sixty cases treated with microscopic clipping rupture for brain aneurysm were retrospectively analyzed. All patients had different degree of cerebral confirmed by using vasospasm postoperatively. Group A （30 patients） treated with nimodipine continuous pumping for 14 days after surgery;Group B （30 patients） received nimodipine group therapy combined with cupping therapy, three acupoint points,once a day. The GCS score, the degree of cerebral vasospasm and mRS score on 3d, 7d and 14d were evaluated. Results After 7d and 14d, GCS score in group B were significantly higher than group A, and the cerebral vasospasm rate （mild ratio） in Group B reached 76.7% and 93.3 %. One month after surgery, group B had better mRS score than the group A （P〈0. 05）, while on 3d after surgery, the GCS score and cerebral vasospasm recovery degree in the two groups showed no statistical difference （P〈0.05）. Conclusion The combination of nimodipine with electricity is effective in cerebral vasospasm caused by rupture of aneurysms.

关 键 词：大脑中动脉瘤 显微手术 脑血管痉挛 电针 尼莫地平 破裂 蛛网膜下腔出血 脑梗死 

分 类 号：R739.41[医药卫生—肿瘤]