| 吕保来 吕继锋 郭珂清 周慧敏 王慧颖 李格.利多卡因联合尼莫地平预防颅内动脉瘤术后脑血管痉挛的临床疗效观察[J].,2016,16(21):4124-4127 |
| 利多卡因联合尼莫地平预防颅内动脉瘤术后脑血管痉挛的临床疗效观察 |
| Clinical Observation of Lidocaine Combined with Nimodipine in Preventionof Cerebral Vasospasmafter Intracranial Aneurysm Operation |
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| DOI： |
| 中文关键词: 利多卡因 尼莫地平 颅内动脉瘤 脑血管痉挛 |
| 英文关键词: Lidocaine Nimodipine Intracranial aneurysms Cerebral vasospasm |
| 基金项目: |
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| 中文摘要: |
| 目的：比较利多卡因加尼莫地平联合治疗与尼莫地平单药治疗在预防颅内动脉瘤术后脑血管痉挛（CVS）的临床疗效与患者
预后评估。方法：选择2012 年1 月-2015 年6 月在我院就诊的颅内动脉瘤患者65 例，通过显微外科开颅动脉瘤夹闭术后，分成对
照组与治疗组。对照组接受常规尼莫地平治疗，治疗组在尼莫地平治疗基础上联合利多卡因治疗，观察比较两组患者在14 天内
的大脑中动脉血流速度变化，并分析两组患者发生CVS、脑梗死、临床死亡情况及患者预后差异。结果：治疗组的大脑中动脉血流
速度在治疗前，治疗后第7 天，治疗后第14 天分别为133.81± 12.35 m/s、78.88± 5.05 m/s、77.28± 4.78 m/s 明显低于对照组的
136.02± 11.67 m/s、96.74± 4.25 m/s、85.96± 7.87 m/s，差异有统计学意义（P=0.000）。治疗组患者最终发生CVS3 例，对照组9 例，
差异有统计学差异（P=0.026）。但在脑梗死例数、死亡例数及最终预后上，未发现明显差异。结论：尼莫地平联合利多卡因治疗预防
颅内动脉瘤夹闭术后CVS 的临床效果显著优于尼莫地平单药组，可以作为术后预防有效的治疗联合方案。 |
| 英文摘要: |
| Objective:To compare the clinical efficacy and prognosis of patients in the prevention of cerebral vasospasm after
intracranial aneurysm operation between lidocaine and nimodipine combined treatment and nimodipine single drug treatment.Methods:Selected 65 cases of patients with intracranial aneurysm treated in our hospital from January 2012 to June 2015, and were divided into
treatment group and control group by microsurgical clipping of aneurysm. The control group were treated with routine nimodipine, and
treatment group were treated with lidocaine on the basis of control group. Observed and compared the changes of the blood flow velocity
in the middle cerebral artery between the two groups, analyzed the situation of CVS, cerebral infarction, clinical death and prognosis of
patients in two groups.Results:Flow velocity of middle cerebral artery in treatment group were 133.81± 12.35 m/s, 78.88± 5.05 m/s and
77.28± 4.78 m/s, which were significantly lower than 136.02± 11.67 m/s, 96.74± 4.25 m/s and 85.96± 7.87 m/s control group before
treatment and 7th, 14th after treatment, the differences were statistically significant (P=0.000), there were 3 cases of patients occurred
CVS, in treatment group, and 9 cases of patients in control group (P=0.026). But there were no significant differences in the number of
cerebral infarction and deaths and the final outcome.Conclusion:The clinical operation of nimodipine combined with lidocaine in the
prevention of intracranial aneurysm clipping surgery is significantly better than that of the single drug group,and it can be used as an effective
treatment for postoperative patients with CVS. |
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