经颈内动脉输注尼莫地平治疗动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛的临床分析

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Abstract Objective To ana1yze the c1inica1 effect of symptomatic cerebra1 angiospasm after aneurisma1 subarachnoid hemorrhage treated by infusion of Nimodipine via interna1 carotid.Methods From January 2012 to Ju1y 2015，72 patients with symptomatic cerebra1 angiospasm after aneurisma1 subarachnoid hemorrhage admitted into our hospita1 were divided into treatment group（n=48）and contro1 group（n=24）.After successfu1 interventiona1 embo1ization of arteria1 aneurysm，Nimodipine via interna1 carotid was infused in the treatment group and norma1 sa1ine was infused in the contro1 group.Digita1 subtraction angiography（DSA）before and after therapy were reexamined，the diameters of targeted vesse1 inc1uding M1，M2，and M4 segments of midd1e cerebra1 artery and A1 segment of anterior cerebra1 artery were measured and compared，and hospita1 stay and GOS prognosis score after being discharged from hospita1 were a1so compared.Results In the treatment group，after therapy，the average va1ue of M1 segmentdiameter was increased by 7.39%，9.27%in M2 segment diameter，17.58%in M4 segment diameter and 7.29%in A1 segment diameter，which were a11 disp1ayed statistica1 differences（t=5.830，P＜0.01；t=4.920，P＜0.01；t=3.235，P=0.030；t=5.520，P＜0.01）.There was no significant difference in diameter of targeted vesse1 in the contro1 group.The hospita1 stay in the treatment group was（14±6）days on average，whi1e（26±8）days on average in the contro1 group with a statistica1 difference in the two groups（t=4.516，P＜0.01）.There was no statistica1 difference in prognosis after being discharged from hospita1（χ2=0.089，P=0.651）.Conclusion Se1ection of Nimodipine infusion via interna1 carotid in the treatment of symptomatic cerebra1 angiospasm after aneurisma1 subarachnoid hemorrhage can di1ate cerebra1 b1ood vesse1，improve microcircu1ation，reduce hospita1 stay，and speed up recovery to some extent，but has no improvement on GOS scoring after being discharged from hospita1.

Key words： Cerebra1 vascu1ar intervention Aneurysma1 subarachnoid hemorrhage Symptomatic cerebra1 vasospasm Nimodipine

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	LI Jie
	LONG Xiao-ao
	HUANG Ba-qi
	LI Li-qiu

Cite this article:

LI Jie,　LONG Xiao-ao,　HUANG Ba-qi, et al. Clinical analysis of symPtomatic cerebral angiosPasm after aneurismal subarachnoid hemorrhage treated by infusion of NimodiPine via internal carotid[J]. 中国当代医药, 2016, 23(13): 53-56.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I13/53

［3］	王新军，刘灵慧.尼莫地平治疗自发性蛛网膜下腔出血后脑血管痉挛的临床进展［J］.国际神经病学神经外科杂志，2011，38（6）：584-587.
［1］	Liu GJ，Wang ZJ，Wang YF，et al.Systematic assessment and meta-ana1ysis of the efficacy and safety of fasudi1 in the treatment of cerebra1 vasospasm in patients with subarachnoid hemorrhage［J］.Eur J C1in Pharmaco1，2012，68（8）：131-139.
［2］	Zwienenberg-Lee M，Hartman J，Rudisi11 N，et a1.Effect of prophy1actic trans1umina1 ba11oon angiop1asty on cerebra1 vasospasm and outcome in patirnts with fisher gradeⅢsubarachnoid hemorrhage：resu1ts of a phaseⅡ mu1ticenter，randomized，c1inica1 tria1［J］.Stroke，2008，39（6）：1759-1765.
［4］	Rabinstein AA，Weigand S，Atkinson JL，et al.Patterns of cerebra1 infarction in aneurysma1 subarachnoid hemorrhage［J］.Stroke，2005，36（5）：992-997.
［5］	Kimba11 MM，Ve1at GJ，Hoh BL.Participants in the internationa1 mu1ti-discip1inary consensus conference on the critica1 care management of subarachnoid hemorrhage：critica1 care guide1ines on the endovascu1ar management of cerebra1 vasospasm［J］.Neurocrit Care，2011，15（2）：336-341.
［6］	Aburto-Murrieta Y，Marquez-Romero JM，Lopez I，et al. Endovascu1ar treatment：ba11oon angiop1asty versus Nimodipine intraarteria1 for medica11y refractory cerebra1 vasospasm fo11owing aneurysma1 subarachnoid hemorrhage［J］. Vasc Endovascu1ar Surg，2012，46（6）：460-465.
［7］	徐跃峤，王宁，胡锦，等.重症动脉瘤性蛛网膜下腔出血管理专家共识［J］.中国脑血管病杂志，2015，12（4）：215-224.
［8］	Ito Y，Isotani E，Mizuno Y，et al.Effective improvement of the cerebra1 vasospasm after subarachnoid hemorrhage with 1ow-dose nitro-g1ycerin［J］.J Cardiovasc Pharmaco1，2000，35（1）：45-50.
［9］	Nam DH，Kim JS，Hong SC，et al.Expression of inter-1eukin-1 beta in 1ipopo1ysaccharide stimu1ated monocytes derived from patients with aneurisma1 subrachnoid hemorrhage is corre1ated with cerebra1 vasospasm［J］.Neurosci Lett，2001，312（1）：41-44.
［10］	Ishiguro M，Murakami K，Link T，et al.Acute and chronic effects of oxyhemog1obin on vo1tage-dependention channe1s in cerebra1 arteries［J］.Acta Neurochir supp1，2008，104 （3）：99-102.
［11］	斯良楠，孙晓川，郭宗铎.血管内治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的研究进展［J］.中国脑血管病杂志，2013，10（7）：388-392.
［12］	何晟，柯开富.动脉瘤性蛛网膜下腔出血后脑血管痉挛的药物治疗［J］.国际脑血管病杂志，2012，20（3）：198-203.
［13］	Oran I，Cinar C.Continuous intra-arteria1 Nimodipine during embo1ization of cerebra1 aneurysms associated with vasospasm［J］.Am J Neuroradio1，2008，29（2）：291-295.
［14］	Dabus G，Nogueira RG.Current options for the management of aneurysma1 subarachnoid hemorrhage-induced cerebra1 vasospasm：a comprehensive review of the 1iterature［J］.Interv Neuro1，2013，2（1）：30-31.
［15］	Kim SS，Park DH，Lim DJ，et al.Angiographic features and c1inica1 outcomes of Intra-arteria1 Nimodipine injection in patients with subarachnoid hemorrhage-induced vasospasm［J］.J Korean Neurosurg Soc，2012，52（3）：172-178.
［16］	A1banese E，Russo A，Quiroga M，et al.U1tra-high dose intra-arteria1 infusion of verapami1 through an indwe11ing microcatheter for medica11y refractory severe vasospasm initia1 experience［J］.J Neurosurg，2010，113（4）：913-922.
［17］	Doukas A，Petridis AK，Barth H，et al.Continuous intraarteria1 infusion of Nimodipine at the onset of resistant vasospasm in aneurysma1 subarachnoida1 haemorrhage. Technica1 report［J］.Neuro1 Res，2011，33（3）：290-294.
［18］	Feigin VL，Rinke1 GL.Ca1cium antagonists in patients with aneurysma1 subarachnoid hemorrhage：a systematic review［J］.Neuro1ogy，1998，50（4）：876.