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目的探究异丙酚联合尼卡地平降低神经介入治疗所产生的脑血管痉挛(cerebral vascular spasm,CVS)的临床效果。方法选取自2013年2月至2015年8月于汉中三二〇一医院行神经介入治疗的患者120例,手术中应用异丙酚联合尼卡地平的患者56例归为观察组,手术中应用异丙酚联合硝酸甘油的患者64例归为对照组,比较2组患者CVS的情况。结果观察组患者总有效率高于对照组患者(P<0.05);观察组患者痉挛时间明显低于对照组患者(P<0.01);2组患者GOS评分比较,差异不具有统计学意义(P>0.05);治疗前大脑中动脉收缩峰流速(MCV Vp)与对照组比较,差异不具有统计学意义(P>0.05);治疗后观察组MCV Vp低于对照组(P<0.05);治疗前2组患者体内肿瘤坏死因子α(TNF-α)与白介素6(IL-6)比较,差异不具有统计学意义(P<0.05);治疗后观察组TNF-α水平低于对照组(P<0.05),观察组IL-6明显低于对照组(P<0.01)。结论异丙酚联合尼卡地平能够明显降低神经介入治疗所产生的CVS,主要对中、重度CVS起作用,而且能够降低TNF-α和IL-6水平。
Objective To investigate the clinical effect of propofol combined with nicardipine in reducing cerebral vascular spasm (CVS) induced by nerve intervention. Methods From February 2013 to August 2015, 120 cases of neurosurgery in Hanzhong Hospital of China were treated with propofol combined with nicardipine. Fifty-six patients undergoing surgery were divided into observation group and surgery group Sixty-four patients with propofol combined with nitroglycerin were assigned to a control group, and CVS was compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group (P <0.05), and the spasticity time of the observation group was significantly lower than that of the control group (P <0.01). The GOS score of the two groups had no statistical significance (P (P> 0.05). Before treatment, the MCV Vp in MCAO group was not significantly different from that in control group (P> 0.05). After treatment, MCV Vp in observation group was lower than that in control group (P <0.05) The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the former two groups had no significant difference (P <0.05); the levels of TNF-α in the observation group were lower than those in the control group <0.05). IL-6 in the observation group was significantly lower than that in the control group (P <0.01). Conclusions Propofol combined with nicardipine can significantly reduce CVS induced by nerve intervention, which mainly acts on moderate and severe CVS, and can reduce the levels of TNF-α and IL-6.