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目的分析研究扩容疗法应用于动脉瘤术后脑血管痉挛中的效果。方法将106例动脉瘤术后脑血管痉挛患者知情同意后分为观察组和对照组,每组53例。对照组患者给予尼莫地平进行治疗,观察组患者在此基础上额外给予胶体溶液静脉输注扩容治疗。对比两组患者经颅多普勒超声(TCD)检查结果、CT检查结果、GCS评分、血液动力学指标变化和不良反应发生率比较。结果观察组患者治疗后7 d和14 d的TCD值显著低于对照组(P<0.01)。观察组患者Fisher评分差异无统计学意义(P>0.05)。观察组患者治疗后7d和14d的GCS评分显著高于对照组(P<0.01)。观察组患者治疗后灌注后的收缩压和舒张压显著低于对照组(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论扩容疗法应用于动脉瘤术后脑血管痉挛中能够扩大患者的血管,使血流更为通畅,脑部得到有效供血,痉挛症状得以改善,但值得注意的是患者血压会有不同幅度的降低,临床应给予更多的重视。
Objective To analyze the effect of dilation therapy on cerebral vasospasm after aneurysm surgery. Methods 106 patients with aneurysm after cerebral vasospasm were divided into observation group and control group with informed consent, each group of 53 cases. Patients in the control group were treated with nimodipine, and patients in the observation group were additionally treated with intravenous dilatation of colloid solution on the basis of this. Comparing the two groups of patients by transcranial Doppler ultrasound (TCD) test results, CT examination results, GCS scores, hemodynamic changes and the incidence of adverse reactions. Results The TCD values of the observation group at 7 and 14 days after treatment were significantly lower than those in the control group (P <0.01). There was no significant difference in Fisher scores between observation group and control group (P> 0.05). The GCS scores of the observation group at 7d and 14d after treatment were significantly higher than those of the control group (P <0.01). The systolic and diastolic blood pressure of the observation group after treatment was significantly lower than that of the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion The application of dilatancy therapy to cerebral vasospasm in patients with aneurysms can expand the blood vessels of the patients and make the blood flow more smooth. The brain is effectively supplied with blood and the symptoms of spasticity can be improved. However, it is worth noting that patients’ blood pressure may have different degrees of decrease , Clinical should pay more attention.