尼莫地平对外伤性蛛网膜下腔出血临床疗效观察.docVIP

尼莫地平对外伤性蛛网膜下腔出血临床疗效观察 　　[摘要] 目的 探讨尼莫地平对外伤性蛛网膜下腔出血的临床疗效，为临床诊治提供参考。 方法 收集南昌大学医学院一附院（进修期间）2014年1～8月收治的160例外伤性蛛网膜下腔出血患者，分为治疗组和对照组，各80例。对照组给予常规治疗，治疗组在对照组治疗基础上给予尼莫地平注射液治疗，动态监测并记录两组患者治疗前和治疗后3、7、14 d的GCS评分、颅内压和MCA流速，所有患者随访3个月，按GOS方法评估不良预后发生率。结果 治疗后第7、14天，治疗组GCS评分高于对照组，颅内压低于对照组，两组差异有统计学意义（P0.05）；治疗后第3、7、14天，治疗组MCA流速低于对照组，两组差异有统计学意义（P0.05）。随访3个月，无失访病例，治疗组良好恢复率高于对照组（61.2% vs 42.5%），两组差异有统计学意义（P0.05）。 结论 早期应用尼莫地平可明显减少CVS的发生，促进患者病情恢复，改善其预后，值得临床推广应用。 　　[关键词] 尼莫地平；蛛网膜下腔出血；临床疗效 　　[中图分类号] R743.35 [文献标识码] A [文章编号] 1674-4721（2015）09（c）-0070-03 　　Clinical curative effect observation of nimodipine for traumatic subarachnoid hemorrhage 　　LIU Bin ZENG Rui-liang LIU Man-chang ZHONG Hui 　　Department of Cerebral Surgery，Ruijin People′s Hospital，Ruijin 342500，China 　　[Abstract] Objective To evaluate the clinical curative effect of nimodipine for traumatic subarachnoid hemorrhage to provide reference for clinical diagnosis and treatment. Methods 160 patients with traumatic subarachnoid hemorrhage treated in the First Affiliated Hospital of Medical School of Nanchang University from January 2014 to August 2014 were collected.Patients were divided into treatment group （n=80） and control group （n=80）.Control group received conventional therapy and treatment group received nimodipine injection treatment on the basis of conventional therapy.GCS score，intracranial pressure and MCA flow velocity before treatment，and after 3，7，14 days treatment in patients of two groups was dynamically monitored and recorded respectively.All patients were followed up for three months，the incidence rate of bad prognosis was assessed according to the GOS score method. Results After 7，14 days treatment，GCS score in treatment group was significantly higher than that of control group，and intracranial pressure was lower than that of control group，the difference was statistically significant（P0.05）.After 3，7，14 days treatment，MCA flow rate of treatment group was lower than that of control group，the difference was sta