法舒地尔动、静脉给药治疗颅内动脉瘤栓塞后脑血管痉挛的对比研究.pdfVIP

184 doi：10．3969／j．issn．1672-7770．2014．03．008 ·脑 血 管 病 治疗 专 题 · 法舒地尔动、静脉给药治疗颅 内动脉瘤栓塞后 脑血管痉挛的对 比研究 陈东，罗伟坚 摘【要】 目的 探讨法舒地尔动脉推注(IAF)与静脉给药对脑动脉瘤栓塞后脑血管痉挛(CVS)的疗效 对比并评估其安全性。方法 介入栓塞治疗后 出现脑血管痉挛 39名患者，随机分成A、B二组。A组，改用 静脉法舒地尔治疗，30mg，3次／d；B组立即行动脉内注射盐酸法舒地尔 (60mg+生理盐水 100ml，60rain缓 慢推注治疗)，连续3d，3d后予常规静脉法舒地尔治疗。结果 B组 IAF治疗后血管痉挛程度明显改善，第 3d、7d、14d的GCS评分均高于A组，3月后GOS评分明显高于A组。结论 IAF能安全有效地缓解蛛网膜 下腔出血后脑血管痉挛的临床症状并改善预后。 【关键词】 蛛网膜下腔出血；脑血管痉挛；盐酸法舒地尔；动脉内给药 【中图分类号】 R743．35 【文献标识码】 A 【文章编号】 1672—7770(2014)03—0184~4 Comparativestudy between intra-arterialinfusion and intravenousoffasudiltreating cerebralvasospasm afterintracranialaneurysm embolizationCHEN Dong，LUO Wei-jian． DepartmentofNeurosurgery，SecondClinicalMedicalCollegeofJinanUniversity(ShenZhenPeople’S Hospita1)，Shenzhen518000，China Abstract：Objective Toobservetheeffectsofintra-arterialinfusionoffasudilhydrochloride (IAF)totreatcerebralvasospasm(CVS)afterintracranialaneurysm embolizationcomparedwith intravenousinfusionandevaluateitssafety．M ethods 39patientsofCVSindiagnosisofaneurysmal subarachnoidhemorrhage(SAH)andtreatedbytheinterventionalembolizationwerecompletely randomlydivided into group A and group B．Group A was to be received intravenous fasudil hydrochloride，per30mgand3timesaday．GroupBhadbeenimmediatelytreatedbyIAF(60mg-I- NS100ml，injectedslowlyfor60minutes)ofr3days，recordingthereactionsoccurredintheprocess ofa~efialinjection．Afterthethirdday，receivedintravenousfasudilhydrochloride．Results The vasospasm degreehad significantly improved in group B afterIAF treatment． TheGCS scores evaluated atthe 3rd，the 7th day and the 14th day in group B aftercerebralvasospasm were significantlyhigherthaningroupA．GroupB’SGOSdegreewasobviouslyhigherthangroupA ’S afterthreemonths．Conclusion IAFcansafelyandeffectivelyrelievetheclinicalsymptomsofCVS andimprovetheprognosis． KeyW ords： SAH；cerebralvasospasm ；fasudilhydrochloride；intra—arterialinfusion 脑血管痉挛(CVS)是蛛网膜下腔 出