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目的研究丹红注射液经穴位注射及静脉注射对动脉瘤破裂致蛛网膜下腔出血患者手术后血管痉挛的疗效。方法将2008年10月至2011年4月经手术治疗的动脉瘤性蛛网膜下腔出血患者189例随机分为丹红注射液穴位注射组83例、丹红注射液静脉注射组56例及尼莫地平静脉注射组50例,分析三组病例脑血管痉挛的发生率及临床疗效。结果 189例动脉瘤性蛛网膜下腔出血患者中,症状性脑血管痉挛的发生率为12.7%(24/189);丹红注射液穴位注射组11例,丹红注射液静脉注射组7例,尼莫地平组6例,三组症状性脑血管痉挛发生率比较差异无统计学意义(2χ=0.047,P>0.05)。三组GCS比较,丹红注射液穴位注射组良好62例,差16例,死亡5例,丹红注射液静脉注射组分别为43例、10例、3例,尼莫地平组分别为38例、10例、2例,三组GCS比较差异无统计学意义(χ2=0.330,P>0.05)。TCD测大脑中动脉流速三组用药前后自身比较差异均有统计学意义(均P<0.05);用药后三组间两两比较差异无统计学意义(P>0.05)。三组用药前后颅内压比较差异均有统计学意义(均P<0.01);三组间治疗后差值比较差异无统计学意义(均P>0.05)。结论丹红注射液穴位注射或静脉注射可减少动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛的发生,经穴位注射或静脉注射丹红注射液治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛均有显著疗效。
Objective To study the efficacy of Danhong injection via acupoint injection and intravenous injection on postoperative vasospasm in patients with aneurysm rupture caused by subarachnoid hemorrhage. Methods A total of 189 patients with aneurysmal subarachnoid hemorrhage who underwent surgical treatment from October 2008 to April 2011 were randomly divided into Danhong injection point injection group (n = 83), Danhong injection intravenous injection group (n = 56) 50 cases were injected intravenously into the venous blood and the incidence of cerebral vasospasm and the clinical curative effect of the three groups were analyzed. Results 189 cases of aneurysmal subarachnoid hemorrhage patients, the incidence of symptomatic cerebral vasospasm was 12.7% (24/189); Danhong injection point injection group 11 cases, Danhong injection intravenous injection group 7 cases , Nimodipine group 6 cases, the incidence of symptomatic cerebral vasospasm was no significant difference among the three groups (2χ = 0.047, P> 0.05). Three groups of GCS comparison, Danhong injection point injection group 62 cases good, 16 poor, 5 deaths, Danhong injection intravenous injection group were 43 cases, 10 cases, 3 cases, nimodipine group were 38 cases , 10 cases and 2 cases. There was no significant difference in GCS between the three groups (χ2 = 0.330, P> 0.05). TCD measured middle cerebral artery velocity in three groups before and after treatment compared to their own differences were statistically significant (all P <0.05); after treatment there was no significant difference between the two groups (P> 0.05). There were significant differences in intracranial pressure between the three groups before and after treatment (all P <0.01). There was no significant difference between the three groups after treatment (all P> 0.05). Conclusion Danhong injection or intravenous injection can reduce the incidence of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Acupoint injection or intravenous injection of Danhong injection for the treatment of cerebrovascular disease after aneurysmal subarachnoid hemorrhage Spasm have significant effect.