Objective To analyze the effects of nimodipine on the tissue oxygen tension and cerebral vascular dynamic indices(CVDI) in patients with severe head injuries.Methods Total of 40 patients with severe head injuries treated in Department of Neurosurgery,Affiliated Hospital of Chuanbei Medical College from Sep.2012 to Sep.2014 were divided into trial group and control group according to random number table method,20 patients in each group.The control group received conventional therapy, including craniotomy, hemostasis,dehydration,anti-infection and corticosteroid administration;the trial group received nimodipine on the basis of conventional therapy lasting till 30 d after injuries.Patients in both groups were under brain partial pressure of brain tissue oxygen (PbtO2) and intracranial pressure monitoring,statistics in different sta-ges were analyzed.CVDI,including mean blood flow velocity(Qmean),mean blood flow in the carotid artery on the injured side(Vmean),resistance and dynamic resistance of cerebral vessels,were measured.Also a Glas-gow Coma Scale(GCS) mark 3 months later was given to every patient.Results The PbtO2 value of the trial group at admission and 8,24,48 and 72 h after treatment were(17 ±2),(20 ±3),(30 ±3),(27 ±2), (32 ±3) mmHg respectively,and that of the control group were (16 ±2),(17 ±1),(18 ±2),(19 ±2), (24 ±3) mmHg respectively.Compared between different time points,the Pbt O2 levels of both groups had increased,compared between the two groups,the Pbt O2 level of the trial group was higher than the control group,the difference was statistically significant (P<0.05).Intracranial pressure levels of the trial group at admission and 8,24,48 and 72 h after treatment were (3.6 ±0.5),(3.6 ±0.7),(2.6 ±0.5),(2.5 ± 0.4),(2.2 ±0.5) kPa respectively,of the control group were (3.8 ±0.6),(3.7 ±0.5),(3.6 ±0.4), (3.2 ±0.5),(2.7 ±0.3) kPa respecitvely,with the progression of the treatment,intracranial pressure lev-els of both groups gradually decreased,but the decline was bigger in the trial group,the differences between groups,time points as well as interaction between groups・ points were statistically significant ( P<0.05 ) . There were no statistically difference in favorable rate between the two groups [ 55.0%( 11/20 ) vs 25.0%(5/20),P >0.05].Conclusion Early use of nimodipine after severe head injuries can improve the patients′tissue oxygen tension and cerebrovascular hemodynamics,which lightens secondary brain damage and promotes the recovery of brain function .%目的：研究分析尼莫地平对重症颅脑损伤患者组织氧分压和血流动力学参数（ CVDI）的影响。方法选择2012年9月至2014年9月于川北医学院附属医院神经外科接受治疗的40例重型颅脑损伤患者，按照随机数字表法分为试验组和对照组，各20例。对照组患者通过开颅手术、脱水、止血、激素、抗炎等常规综合疗法进行治疗；试验组患者于常规治疗的基础上，联合使用尼莫地平，并连续用药直至伤后30 d。两组患者均接受持续性的脑组织氧分压（PbtO2）和颅内压监测，对不同时段PbtO2和颅内压水平统计分析，此外对不同时间点患者的平均血流量（Qmean）、伤侧颈动脉的平均血流速度（Vmean）、动态血管阻力以及脑血管阻力进行观察记录，每例患者在伤后3个月进行格拉斯哥昏迷（GCS）评分。结果试验组入院及治疗8、24、48、72 h时的PbtO2水平分别为（17±2）、（20±3）、（30±3）、（27±2）、（32±3） mmHg（1 mmHg ＝0．133 kPa），对照组的 Pbt O2水平分别为（16±2）、（17±1）、（18±2）、（19±2）、（24±3） mmHg，组内不同时点间比较，术后两组 PbtO2水平均有提升，组间比较，实验组PbtO2水平高于对照组（P＜0．05）。入院及治疗8、24、48、72 h时试验组的颅内压水平分别为（3．6±0．5）、（3．6±0．7）、（2．6±0．5）、（2．5±0．4）、（2．2±0．5） kPa，对照组的颅内压水平分别为（3．8±0．6）、（3．7±0．5）、（3．6±0．4）、（3．2±0．5）、（2．7±0．3） kPa，随着治疗时间延长，两组颅内压水平均呈逐渐下降趋势，但试验组下降幅度更大，两组在组间、时点间以及组间・不同时点间交互效应差异均有统计学意义（ P ＜0．05）。两组良好率差异无统计学意义[55．0％（11／20）比25．0％（5／20），P＞0．05]。结论在重型颅脑外伤之后及早使用尼莫地平治疗，能够增加患者组织氧分压，促进脑部血液循环，从而减轻继发性的脑损伤减轻并促进脑部功能的恢复。
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