法舒地尔与尼莫地平对脑血管痉挛后脑脊液S100蛋白、血清NSE水平变化分析

摘要

Objective To investigate the effect of prevention and treatment of the application of the method of intracranial aneurysms ICA in patients with fasudil and nimodipine on cerebral vascular spasm(CVS).Method Sixty-two cases of(ICA)were selected from January 2014 to January 2016 in the Department of Neurosurgery of our hospital. Were randomly divided into study group and control group with thirty-one cases in each, the study group was given fasudil combined with nimodipine, control group was given nimodipine, The blood flow velocity of the two groups of patients were compared before and after operation, the S100 protein in cerebrospinal fluid (CSF) and serum neuron specific alcohol (NSE) were compared.Results Preoperative, the study group and the control group of patients with proximal and distal end of the clip, blood flow velocity, MCA blood flow velocity, CSF S100, serum NSE levels were not statistically significant (P>0.05); On the seventh day after surgery, the blood flow velocity in the proximal and distal ends of the study group was higher than that in the control group (P<0.05),the difference of MCA blood flow velocity between the two groups was not statistically significant (P>0.05); After surgery, the CSF levels of S100 and serum NSE in the study group were significantly lower than those in the control group (P<0.05); On the 28 day after operation, the healing rate of the study group was 80.65%, significantly higher than that of the control group 58.06% (P<0.05); The total effective rate of the study group was 96.77% and 90.23% of the control group was not statistically significant (P>0.05).Conclusion The application of the method of ICA in patients with fasudil and nimodipine to the prevention and treatment of CVS better, reduce brain damage, improve clinical curative effect.%目的 探讨颅内动脉瘤(ICA)患者术中应用法舒地尔与尼莫地平对脑血管痉挛(CVS)的预防及治疗作用.方法 选取2014年1月至2016年1月在本院神经外科接受显微外科夹闭手术的62例ICA患者采用抽签法随机分为研究组和对照组各31例,研究组给予法舒地尔联合尼莫地平,对照组仅给予尼莫地平,对比两组患者手术前后夹闭血管血流速度、脑脊液(CSF)中S100蛋白、血清神经元特异化烯醇化酶(NSE)水平等变化.结果 术前,研究组和对照组患者的夹闭动脉瘤近心端、远心端的血流速度、MCA的血流速度、CSF S100、血清NSE水平差异无统计学意义(P>0.05);术后7d,研究组的夹闭动脉瘤近心端、远心端的血流速度均高于对照组(P<0.05),两组患者的MCA血流速度差异无统计学意义(P>0.05);术后,研究组的CSFS100、血清NSE水平均显著的低于对照组(P<0.05);术后28d,研究组的愈显率80.65%显著的高于对照组的58.06%(P<0.05);研究组的总有效率96.77%与对照组的90.23%差异无统计学意义(P>0.05).结论 ICA患者术中应用法舒地尔联合尼莫地平能够更好的预防和治疗CVS,减少脑损伤,有利于提高临床治疗效果.