法舒地尔联合尼莫地平预防脑动脉瘤术后脑血管痉挛的临床效果分析  

Clinical effect analysis of fasudil combined with nimodipine in preventing cerebral vasospasm after cerebral aneurysm surgery

作　　者：巴传 吐鲁洪江·乌苏尔 杨晓磊 宋博 BA Chuan;WUSUER Tuluhongjiang;YANG Xiaolei;SONG Bo(Department of Brain Surgery,Dushanzi People's Hospital,Karamay 833699,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区克拉玛依市独山子人民医院脑外科,新疆维吾尔自治区克拉玛依833699

出　　处：《世界临床药物》2022年第8期1058-1062,共5页World Clinical Drug

摘　　要：目的 脑血管痉挛是脑动脉瘤患者接受血管内介入栓塞术治疗后的常见并发症,现分析通过法舒地尔联合尼莫地平对该并发症进行预防的临床效果。方法 采用随机数字表法将2019年1月1日至2020年12月31日期间于新疆维吾尔自治区克拉玛依市独山子人民医院接受血管内介入栓塞术治疗的脑动脉瘤患者,共计80例,分为对照组与观察组,各40例。所有患者均接受尼莫地平治疗,观察组联用法舒地尔治疗。对比治疗效果。结果 观察组总有效率高于对照组(97.50% vs 80.00%,P<0.05);观察组改良Rankin量表(modified Rankin scale,mRS)显著低于对照组[(0.90±0.15) vs (2.80±0.28),P<0.05];观察组格拉斯哥昏迷(Glasgow Coma Scale,GCS)及Barthel评分均显著高于对照组GCS和Barthel评分,分别为[(14.49±0.80) vs (10.98±0.65),P<0.05]、[(79.97±4.44) vs (55.82±3.35),P<0.05];观察组大脑后动脉(posterior cerebral artery,PCA)及大脑中动脉(middle cerebral artery,MCA)平均血流速度均显著低于对照组PCA及MCA,分别为[(38.41±1.76) vs (45.54±2.99)cm/s,P<0.05]、[(81.44±2.24) vs (92.33±4.43)cm/s,P<0.05];观察组患者基质金属蛋白酶(matrix metalloprotein-9,MMP-9)及核因子κB(nuclear factor kappa-B,NF-κB)均显著低于对照组MMP-9及NF-κB,分别为[(133.33±8.88) vs (165.44±10.55)nmol/L,P<0.05]、[(0.12±0.01) vs (0.25±0.03)nmol/L,P<0.05];两组不良反应发生率比较无显著差异(P>0.05)。结论 血管内介入栓塞术后的脑动脉瘤患者,给予法舒地尔联合尼莫地平治疗,可有效降低术后脑血管痉挛的发生风险,降低动脉血流速度和昏迷指数,改善神经功能,控制血清炎症因子水平,效果显著且安全性较高。Objective Cerebral vasospasm is a common postoperative complication in patients with cerebral aneurysms treated by endovascular embolization.This paper analyzes the clinical effect of fasudil combined with nimodipine in the prevention of this complication.Methods Total 80 patients with cerebral aneurysms who received endovascular embolization in Dushanzi People's hospital from January 1,2019 to December 31,2020 were randomly divided into control group and observation group,with 40 patients in each group.All patients were treated with nimodipine,and the observation group was treated with fasudil combined with nimodipine.The treatment effects of the two groups were compared.Results The total effective rates of the observation group were higher than that of control group(97.50%vs 80.00%,P<0.05).The modified Rankin scale(mRS)of observation group was significantly lower than that of control group[(0.90±0.15)vs(2.80±0.28),P<0.05].The Glasgow Coma Scale(GCS)and Barthel score of observation group were significantly higher than those of control group[(14.49±0.80)vs(10.98±0.65),P<0.05],[(79.97±4.44)vs(55.82±3.35),P<0.05].The mean blood flow of posterior cerebral artery(PCA)and middle cerebral artery(MCA)of observation group were significantly lower than those of control group[(38.41±1.76)vs(45.54±2.99)cm/s,P<0.05],[(81.44±2.24)vs(92.33±4.43)cm/s,P<0.05].Matrix metalloprotein-9(MMP-9)and nuclear factor kappa-B(NF-κB)of observation group were significantly lower than those of control group[(133.33±8.88)vs(165.44±10.55)nmol/L,P<0.05],[(0.12±0.01)vs(0.25±0.03)nmol/L,P<0.05].There was no significant difference in the incidence of adverse reactions after treatment between the two groups P>0.05.Conclusion Fasudil combined with nimodipine in the treatment of cerebral aneurysms patients after intravascular interventional embolization can effectively reduce the risk of postoperative cerebral vasospasm,reduce arterial blood flow velocity and coma index,effectively improve neurological function,and control the level of

关 键 词：法舒地尔 尼莫地平 脑动脉瘤 脑血管痉挛 临床效果 

分 类 号：R743[医药卫生—神经病学与精神病学]