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目的观察尼莫地平在蛛网膜下腔出血患者中的应用效果。方法选取2012年6月至2014年6月于我院接受治疗的80例蛛网膜下腔出血患者,随机将其分为对照组与观察组两组,对照组40例,给予常规基础治疗和止血处理,观察组40例,在对照组基础上加用尼莫地平治疗,比较治疗不同阶段两组患者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及白介素-8(IL-8)浓度水平的变化情况,统计两组患者治疗前后GCS评分及颅内压的变化情况,记录两组患者脑血管痉挛发生率。结果治疗后,观察组TNF-α水平为(1.25±0.06)μg/L,IL-6为(0.28±0.02)μg/L,IL-8为(0.42±0.02)μg/L,均明显低于对照组(P<0.05);观察组GCS评分上升至(16.5±2.1)分,明显高于对照组,颅内压降低至(2.0±0.4)k Pa,低于对照组,且脑血管痉挛发生率为5.0%,明显低于对照组的27.5%(P<0.05)。结论在蛛网膜下腔出血早期采用尼莫地平方案治疗,可发挥有效的血管扩张作用,抑制脑血管超微结构的病理化改变,促进脑组织生理功能的恢复,降低患者血清炎性因子水平,稳定颅内压,降低脑血管痉挛发生率,值得推广与应用。
Objective To observe the effect of nimodipine in patients with subarachnoid hemorrhage. Methods Eighty patients with subarachnoid hemorrhage treated in our hospital from June 2012 to June 2014 were randomly divided into control group and observation group, 40 cases in control group were given routine basic treatment and hemostasis (N = 40) were treated with nimodipine in the control group. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels were measured. The changes of GCS score and intracranial pressure before and after treatment were recorded. The incidence of cerebral vasospasm was recorded in both groups. Results After treatment, the level of TNF-α in the observation group was (1.25 ± 0.06) μg / L, IL-6 was 0.28 ± 0.02 μg / L and IL-8 was 0.42 ± 0.02 μg / L, (P <0.05). The score of GCS in observation group increased to (16.5 ± 2.1) points, which was significantly higher than that in control group. The intracranial pressure decreased to (2.0 ± 0.4) kPa, which was lower than that in control group. Cerebral vasospasm occurred The rate was 5.0%, significantly lower than that of the control group (27.5%, P <0.05). Conclusion The treatment of nimodipine in the early stage of subarachnoid hemorrhage can exert effective vasodilatation, inhibit the pathological changes of cerebrovascular ultrastructure, promote the recovery of physiological function of brain tissue, decrease the level of serum inflammatory cytokines, Stable intracranial pressure and reduce the incidence of cerebral vasospasm, it is worth promoting and application.