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目的探讨法舒地尔联合高压氧对蛛网膜下腔出血(SAH)后脑血管痉挛的疗效及安全性。方法将88例SAH患者,抽签法分为法舒地尔联合高压氧治疗组(A组),共22例;法舒地尔组(B组),共30例;尼莫地平组(C组),共36例,比较用药前后3组血压、脑CT、经颅多普勒变化。结果 A、B组对血压无影响,C组患者血压下降,差异有统计学意义(P<0.05);脑CT:治疗7 d后共出现新的脑梗塞患者25例(A组4例,B组7例,C组14例),治疗21 d后剩下15例(A组1例,B组4例,C组10例)。P<0.05组间差异有统计学意义。治疗前MCA的平均流速(cm/s):A组104.27±45.21,治疗后第7,21天分别下降为89.34±15.38,66.07±19.85,B组分别为102.67±30.82,85.64±15.54,78.43±13.39,C组分别为101.57±35.27,99.30±14.18,88.07±10.80,组间比较治疗后第7天差异无统计学意义。治疗后第21天差异有统计学意义。结论盐酸法舒地尔联合高压氧治疗能够有效缓解脑血管痉挛,促进疾病恢复,治疗方法安全、可靠。
Objective To investigate the efficacy and safety of fasudil combined with hyperbaric oxygen on cerebral vasospasm after subarachnoid hemorrhage (SAH). Methods Eighty-eight patients with SAH were randomly divided into Fasudil combined with hyperbaric oxygen therapy group (A group), and 22 patients in fasudil group (B group), 30 patients in Nimodipine group (C group) ), A total of 36 cases, before and after treatment compared three groups of blood pressure, brain CT, transcranial Doppler changes. Results Blood pressure was not affected in groups A and B, and blood pressure was decreased in group C (P <0.05). Brain CT was found in 25 cases of new cerebral infarction after 7 days of treatment (group A, 4 cases, B 7 cases in group C and 14 cases in group C), and 15 cases remained after 21 days of treatment (group A in 1, group B in 4 and group C in 10). P <0.05 difference between groups was statistically significant. The mean flow rate of MCA before treatment (cm / s) was 104.27 ± 45.21 in group A, and decreased to 89.34 ± 15.38,66.07 ± 19.85 on days 7 and 21 after treatment, respectively, and 102.67 ± 30.82 and 85.64 ± 15.54 and 78.43 ± 13.39, C were 101.57 ± 35.27,99.30 ± 14.18,88.07 ± 10.80, no significant difference between the 7th day after treatment. After 21 days of treatment, the difference was statistically significant. Conclusion Fasudil hydrochloride combined with hyperbaric oxygen therapy can effectively relieve cerebral vasospasm and promote the recovery of the disease. The treatment is safe and reliable.