Rho激酶抑制剂联合甘露醇对颅内动脉瘤术后脑水肿患者NIHSS评分及脑水肿缩小程度的影响  

Effect of Rho Kinase Inhibitor Combined with Mannitol on NIHSS Score and Degree of Cerebral Edema Reduction in Patients with Cerebral Edema after Intracranial Aneurysm Operation

作　　者：柯学庭 杨炳湖[2] Ke Xueting;Yang Binghu(Department of Neurosurgery,People＇s Hospital of High Teeh District in Huizhou Zhongkai,Huizhou 516229,China;Center People＇s Hospital in Huizhou,Huizhou 516000,China)

机构地区：[1]惠州仲恺高新区人民医院神经外科,广东惠州516229 [2]惠州市中心人民医院,广东惠州516000

出　　处：《哈尔滨医药》2018年第5期401-403,共3页Harbin Medical Journal

摘　　要：目的研究Rho激酶抑制剂联合甘露醇治疗颅内动脉瘤术后脑水肿患者的临床效果。方法选取我院2014年10月至2017年7月我院联合惠州市中心人民医院收治的颅内动脉瘤术后脑水肿患者86例,按治疗方案不同分组,各43例。对照组给予甘露醇治疗,观察组给予Rho激酶抑制剂(盐酸法舒地尔)+甘露醇治疗。比较两组疗效、治疗前后神经功能缺损(NIHSS)评分、脑水肿范围、脑动脉血流速度及不良反应。结果观察组治疗总有效率97.67%,高于对照组81.40%,差异有统计学意义(P<0.05);治疗前,两组NIHSS评分、脑水肿范围无明显差异(P>0.05);治疗3 d后、治疗7 d后两组NIHSS评分、脑水肿范围呈下降趋势,且观察组NIHSS评分、脑水肿范围下降幅度较大,两组NIHSS评分、脑水肿范围组间、时间点、组间·时间点交互作用相比,差异有统计学意义(P<0.05);治疗前,两组脑动脉血流速度无明显差异(P>0.05);治疗7 d后大脑前动脉、后动脉、中动脉血流速度高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率9.30%与对照组6.98%相比无明显差异(P>0.05)。结论Rho激酶抑制剂联合甘露醇治疗颅内动脉瘤术后脑水肿患者疗效显著,可促进脑水肿缩小,加快神经功能恢复,提高脑动脉血流速度,且不增加药物不良反应。Objective To investigate the clinical effect ofRho kinase inhibitor combined with mannitolin treating patients with cerebral edema after intracranial aneurysm operation.Methods A total of 86 patients with cerebral edema after intracranial aneurysm surgery in our hospital and the Center People′s Hospital in Huizhou from October 2014 to July 2017 were selected and divided into two groups according to the treatment plan,each with 43 cases.The control group was treated with mannitol,and the observation group was treated with Rho kinase inhibitor（fasudil）＋mannitol.The curative effect,the score of nerve function defect（NIHSS） before and after treatment,the range of cerebral edema,the velocity of cerebral artery blood flow and the adverse reactions of two groups were observed and compared.Results The total effective rate of treatment in the observation group was 97.67%（42/43）,higher than that of the control group 81.40%（35/43）,and the difference was statistically significant（P〈0.05）.Before treatment,there were insignificant differences between the two groups in NIHSS scores and the range of brain edema（P〉0.05）.After 3 d and 7 d of treatment,the NIHSS score and cerebral edema range of two groups decreased,and the NIHSS score and cerebral edema range of the observation group decreased greatly.The NIHSS scores of the two groups,the inter-group brain edemarange,time point and interaction of inter-group·time point were compared,and the difference was statistically significant（P〈0.05）.Before treatment,there were insignificant differences in the velocity of cerebral artery blood flow between the two groups（P〉0.05）.After 7 d of treatment,the blood flow velocity of the anterior cerebral artery,posterior artery and middle artery was higher than that of the control group.The difference was statistically significant（P〈0.05）.The incidence of adverse reactions in the observation group was 9.30%（4/43）,which was not significantly different from that in the control group 6.98%（3/

关 键 词：颅内动脉瘤术后脑水肿 甘露醇 Rho激酶抑制 

分 类 号：R651[医药卫生—外科学]