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目的观察依达拉奉注射液治疗脑血管痉挛的临床效果。方法选择2010年8月—2012年8月收治的脑血管痉挛患者60例,随机分为对照组和治疗组各30例,两组均给予常规治疗,对照组失去手术机会的患者采用脱水剂、止血剂和钙离子拮抗剂治疗;动脉瘤术后患者采用“3H”疗法[高血压(Hypertension)、高血容量(Hemodilution)和高血液稀释度(Hemodilution)疗法]+尼莫地平注射液,均治疗2周。治疗组在以上治疗的基础上同时给予依达拉奉注射液30 mg加入100 ml生理盐水中静脉滴注,30 min内滴完,2次/d,共治疗2周。比较两组治疗前后大脑中动脉血流速度、临床疗效、预后及不良反应。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗前大脑中动脉血流速度对照组(145.47±20.95)cm/s,治疗组(147.37±17.61)cm/s,两组比较差异无统计学意义(P>0.05);治疗后对照组(117.17±28.24)cm/s,治疗组(104.10±21.17)cm/s,两组比较差异有统计学意义(P<0.05);治疗前后两组大脑中动脉血流速度组内比较差异均有统计学意义(均P<0.05)。总有效率对照组80.00%,治疗组96.67%,两组比较差异有统计学意义(P<0.05)。两组预后对照组良好13例,中残6例,重残5例,植物生存3例,死亡3例;治疗组良好23例,中残6例,重残0例,植物生存0例,死亡1例。两组比较差异有统计学意义(P<0.05)。两组不良反应发生率均为10.00%,比较差异无统计学意义(P>0.05)。结论依达拉奉注射液作为一种新型自由基清除剂治疗脑血管痉挛效果满意。
Objective To observe the clinical effect of edaravone injection in treating cerebral vasospasm. Methods Sixty patients with cerebral vasospasm who were admitted to our hospital from August 2010 to August 2012 were randomly divided into control group and treatment group, with 30 cases in each group. Both groups were given routine treatment. In the control group, the patients who lost the operation chance were treated with dehydrating agent, Hemostatic agents and calcium antagonists; postoperative aneurysm patients treated with “3H” therapy [Hypertension, Hemodilution and Hemodilution] + nimodipine , Were treated for 2 weeks. On the basis of the above treatment, the treatment group was treated with edaravone 30 mg intravenously in 100 ml of normal saline for 30 minutes and dripped twice a day for 2 weeks. The blood flow velocity, clinical efficacy, prognosis and adverse reactions of middle cerebral artery were compared between the two groups before and after treatment. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The blood flow velocity of the middle cerebral artery before treatment was (145.47 ± 20.95) cm / s in the control group (147.37 ± 17.61) cm / s, with no significant difference between the two groups (P> 0.05) 117.17 ± 28.24) cm / s, the treatment group (104.10 ± 21.17) cm / s, the difference between the two groups was statistically significant (P <0.05); before and after treatment, the middle cerebral artery blood flow velocity in the two groups were statistically significant differences Significance (both P <0.05). The total effective rate was 80.00% in the control group and 96.67% in the treatment group, with significant difference between the two groups (P <0.05). The prognosis of the two groups was good in control group 13 cases, 6 cases of moderate disability, 5 cases of severe disability, 3 cases of plant survival and 3 cases of death; the treatment group was 23 cases of good, 6 cases of disability, 0 case of severe disability, 0 case of plant survival, 0 case of death 1 case. The difference between the two groups was statistically significant (P <0.05). The incidence of adverse reactions in both groups was 10.00%, with no significant difference (P> 0.05). Conclusion Edaravone injection as a new free radical scavenger treatment of cerebral vasospasm with satisfactory results.