法舒地尔治疗蛛网膜下腔出血患者的临床研究(1)
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【摘要】 目的 观察法舒地尔注射液治疗蛛网膜下腔出血后脑血管痉挛的疗效和安全性。方法 选择在本院住院的蛛网膜下腔出血患者67例，随机分为两组，观察组34例，对照组33例，两组患者均在常规治疗的基础上，观察组给予法舒地尔注射液治疗，对照组给予尼莫地平注射液治疗，疗程15 d，疗程结束后比较两组患者的临床表现、病情变化、意识的改善、血压及Hunt&Hess分级等指标。结果 两组患者在疗程结束后，总有效率比较差异有统计学意义，观察组的疗效明显优于对照组(P<0.05)，观察组的不良反应发生率低于对照组。结论 治疗蛛网膜下腔出血后脑血管痉挛，法舒地尔注射液是一种较尼莫地平同样安全而疗效更好的药物。
【关键词】 蛛网膜下腔出血；血管痉挛；法舒地尔；尼莫地平
Clinical study of Fashudier treatment on the patients with subarachnoid hemorrhage LIN Song-mei,GAO Wen,CHEN Zhun-ling. Jiaozhou Central Hospital,Qingdao 266300,China
【Abstract】 Objective To observe the efficacy and safety of Fashudier injection treatment of cerebral vasospasm after subarachnoid hemorrhage. Methods 67 patients in our hospital with subarachnoid hemorrhage were randomly divided into two groups, 34 patients in observation group, 33 cases in control group, all patients in two groups were on the basis of conventional therapy, the observation group were given Fashudier injection, the control group received Nimodipine injection treatment course of 15 days, two groups were compared after treatment of clinical manifestations, the condition changes, the improvement of consciousness, blood pressure and other indicators of Hunt & Hess grade. Results The patients at the end of treatment, the total effective rate was statistically significant difference between the observed group significantly better than the control group(P<0.05), observation of adverse reactions was lower than the control group. Conclusion The treatment of cerebral vasospasm after subarachnoid hemorrhage, injection of fasudil is a relatively safe and efficacy of nimodipine as better drugs.
【Key words】 Subarachnoid hemorrhage; Vasospasm; Fashudier; Nimodipine
脑动脉瘤是脑动脉的局限性异常扩大，自发性蛛网膜下腔出血是一种严重威胁人类生命安全的疾病，而动脉瘤性蛛网膜下腔出血(SAH)占自发性蛛网膜下腔出血的51%[1]，动脉瘤性后脑血管痉挛(CVS)，是致死致残的主要原因。近年来盐酸法舒地尔以其较强的扩张痉挛脑血管的独特作用机制及较少的副作用受到临床工作者越来越多的关注。本研究以尼莫地平为对照，探讨盐酸法舒地尔对SAH后脑血管痉挛的疗效。现报告如下。
1 资料与方法
1.1 一般资料 脑动脉瘤破裂患者。选入标准：动脉瘤破裂日为0病日，3 d内进行手术治疗的患者；术前或术后48 h内CT证实有SAH，估计发生CVS危险性较高；动脉瘤初次破裂；术前Hunt＆Hess分级为Ⅰ～Ⅳ级。除外标准：神经症状过于严重；有严重内脏疾病或代谢性疾病(如糖尿病)；有主要脑血管阻塞或烟雾病，陈旧性脑梗死或脑内血肿，巨大颅内动脉瘤等重症脑血管障碍。67例随机分为观察组和对照组。观察组34例，男、女各17例，年龄44～75岁，平均(60.23±8.56)岁；对照组33例，男17例，女16例 ......
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