依达拉奉联合尼莫地平治疗外伤性蛛网膜下腔出血后脑血管痉挛的临床效果  

Clinical effect of edaravone combined with nimodipine in the treatment of cerebral vasospasm after traumatic subarachnoid hemorrhage

作　　者：伏光辉 袁涛 王建伟 康新 何洪雨 FU Guanghui;YUAN Tao;WANG Jianwei;KANG Xin;HE Hongyu(Lianyungang Eastern Hospital,Jiangsu Province,Lianyungang 222042,China)

机构地区：[1]江苏省连云港市市立东方医院,222042

出　　处：《临床合理用药杂志》2022年第1期38-40,43,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察依达拉奉联合尼莫地平治疗外伤性蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的临床效果,为实际应用提供参考依据。方法选取2018年1月-2020年1月江苏省连云港市市立东方医院收治的外伤性SAH后CVS患者60例,采用随机数字表法分为研究组和对照组各30例。在吸氧、镇静及止血治疗基础上,对照组予以尼莫地平治疗,研究组在对照组基础上加用依达拉奉,2组均治疗2周。比较2组患者临床疗效,治疗前后大脑中动脉(MCA)血流速度、炎性因子水平、神经功能缺损(NIHSS)评分及不良反应。结果研究组患者临床总有效率为100.00%,高于对照组的80.00%(χ^(2)=4.630,P=0.024)。治疗2周后,2组患者MCA血流速度均低于治疗前,且研究组低于对照组(P<0.05);2组患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.01);2组患者NIHSS评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.01)。研究组患者不良反应总发生率为20.00%,与对照组的16.67%比较,差异无统计学意义(χ^(2)=0.111,P=0.739)。结论依达拉奉联合尼莫地平有利于降低SAH患者MCA血流速度,减轻机体炎性反应,可更好地发挥脑保护作用,从而对预防CVS具有积极意义,且疗效更好,用药安全性较高,值得临床推广应用。Objective To observe the clinical effect of edaravone combined with nimodipine in the treatment of cerebral vasospasm(CVS)after traumatic subarachnoid hemorrhage(SAH),and to provide reference for practical application.Methods A total of 60 patients with CVS after SAH were selected from January 2018 to January 2020 in Lianyungang Eastern Hospital of Jiangsu Province.By random number table method,they were divided into study group and control group,each of30 cases.On the basis of oxygen inhalation,sedation and hemostasis,the control group was treated with nimodipine,and the study group was treated with edaravone in addition to the control group,both groups were treated for 2 weeks.The clinical efficacy,blood flow velocity of middle cerebral artery(MCA),inflammatory factors,NIHSS score before and after treatment and adverse reactions were compared between 2 groups.Results The total clinical effective rate of the study group was100.00%,higher than 80.00%of the control group(χ^(2)=4.630,P=0.024).After 2 weeks of treatment,the blood flow velocity of MCA in both groups were lower than before,and the study group was lower than the control group(P<0.05);The serum levels of IL-6,TNF-αand CRP in 2 groups were lower than before treatment,and study group was lower than control group,the differences were statistically significant(P<0.01);The NIHSS scores of 2 groups were lower than before,and the study group was lower than the control group,the differences were statistically significant(P<0.01).The total incidence of adverse reactions in the study group was 20.00%,which was not statistically significant compared with 16.67%in the control group(χ^(2)=0.111,P=0.739).Conclusion Edaravone combined with nimodipine can reduce THE MCA blood flow velocity of SAH patients,reduce the inflammatory response of the body,and better play the brain protection effect,has a positive significance for the prevention of CVS,and has better efficacy and safety,worthy of clinical application.

关 键 词：蛛网膜下腔出血 外伤性 脑血管痉挛 依达拉奉 尼莫地平 

分 类 号：R74[医药卫生—神经病学与精神病学]