目的 观察马来酸桂哌齐特联合尼莫地平治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床疗效.方法 选择2014年1月至2016年1月我院神经外科收治的90例动脉瘤性蛛网膜下隙出血后脑血管痉挛患者为研究对象,根据随机数字表法随机分为A组、B组和C组,每组30例,分别予以尼莫地平、马来酸桂哌齐特与尼莫地平联合马来酸桂哌齐特治疗,疗程均为14 d.比较三组患者格拉斯哥昏迷量表评分(GCS)及大脑中动脉血流速度的变化.结果 治疗后,A组、B组、C组患者大脑中动脉血流速度分别为(109.12±14.71)cm/s、(104.78±15.11)cm/s、(96.22±11.52)cm/s,均较治疗前的(165.79±25.82)cm/s、(167.35±24.79)cm/s、(166.28±23.96)cm/s明显降低,GCS评分分别为(11.18±2.01)分、(11.24±2.14)分、(13.93±2.94)分,均较治疗前的(7.24±1.81)分、(7.43±1.75)分、(7.34±1.52)分明显提高,差异均有统计学意义(P<0.05);其中A组、B组比较差异无统计学意义(P>0.05),但是A组、B组与C组比较,差异均有统计学意义(P<0.05).结论 尼莫地平、马来酸桂哌齐特治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛均具有较好的临床疗效,两者联合应用可进一步提高临床疗效.%Objective To compare the clinical efficacy of cinepazide maleate and nimodipine in the treatment of cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (SAH). Methods A total of 90 patients with CVS after aneurismal SAH, who admitted to Department of Neurosurgery of our hospital from January 2014 to January 2016 were selected and randomly divided into group A, group B, group C according to the random number table method, with 30 patients in each group. The group A, group B and group C were respectively treated by nimodipine, cinepazide maleate and nimodipine combined with cinepazide maleate for 14 days. Glasgow coma amount table score (GCS) and middle cerebral artery blood flow velocity changes in the three groups were compared. Results After treatment, cere-bral artery blood flow velocity in group A, group B, group C were (109.12 ± 14.71) cm/s, (104.78 ± 15.11) cm/s, (96.22 ± 11.52) cm/s, respectively, which were significantly lower than (165.79 ± 25.82) cm/s, (167.35 ± 24.79) cm/s, (166.28 ± 23.96) cm/s before treatment;GCS scores were (11.18±2.01) points, (11.24±2.14) points, (13.93±2.94) points, respective-ly, which were significantly higher than (7.24±1.81) points, (7.43±1.75) points and (7.34±1.52) points before treatment, and all of the above differences before and after treatment were statistically significant (P<0.05). There was no statistical-ly significant difference between group A and group B (P>0.05), but there were significant different between group A, group B and group C (P<0.05). Conclusion Nimodipine and cinepazide maleate alone have a good clinical efficacy in the treatment of CVS after aneurismal SAH, and the combination of nimodipine and cinepazide maleate can further im-prove clinical outcomes.
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