中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
4期
370-372
,共3页
维拉帕米%动脉瘤%脑血管痉挛%灌注
維拉帕米%動脈瘤%腦血管痙攣%灌註
유랍파미%동맥류%뇌혈관경련%관주
Verapamil%Aneurysm%Vasospasm%Infusion
目的 研究动脉内灌注维拉帕米治疗动脉瘤性蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的有效性及使用方法.方法 对13例处理完动脉瘤后出现CVS的SAH患者进行脑血管造影,并在动脉内灌注维拉帕米,治疗过程中监测血压、心率,记录灌注前后经颅多普勒超声结果,随访6个月并进行GOS评分.结果 本组13例共实施了16根动脉内灌注治疗,灌注前后相比较,CVS造影上改善9例,临床症状改善8例,症状无变化5例,多普勒超声检查大脑中动脉的平均流速由治疗前的(178 ±4) cm/s降至治疗后的(139±4) cm/s(P＜0.05),监测心率和平均动脉压无明显变化.所有患者随访6个月,GOS评分:恢复良好10例,中度病残但生活自理2例,重度病残生活不能自理1例.结论 动脉内灌注维拉帕米治疗动脉瘤性SAH后CVS是安全可行的,中等剂量使用可有效改善CVS,同时对全身的血流动力方面无显著影响.
目的 研究動脈內灌註維拉帕米治療動脈瘤性蛛網膜下腔齣血(SAH)後腦血管痙攣(CVS)的有效性及使用方法.方法 對13例處理完動脈瘤後齣現CVS的SAH患者進行腦血管造影,併在動脈內灌註維拉帕米,治療過程中鑑測血壓、心率,記錄灌註前後經顱多普勒超聲結果,隨訪6箇月併進行GOS評分.結果 本組13例共實施瞭16根動脈內灌註治療,灌註前後相比較,CVS造影上改善9例,臨床癥狀改善8例,癥狀無變化5例,多普勒超聲檢查大腦中動脈的平均流速由治療前的(178 ±4) cm/s降至治療後的(139±4) cm/s(P＜0.05),鑑測心率和平均動脈壓無明顯變化.所有患者隨訪6箇月,GOS評分:恢複良好10例,中度病殘但生活自理2例,重度病殘生活不能自理1例.結論 動脈內灌註維拉帕米治療動脈瘤性SAH後CVS是安全可行的,中等劑量使用可有效改善CVS,同時對全身的血流動力方麵無顯著影響.
목적 연구동맥내관주유랍파미치료동맥류성주망막하강출혈(SAH)후뇌혈관경련(CVS)적유효성급사용방법.방법 대13례처리완동맥류후출현CVS적SAH환자진행뇌혈관조영,병재동맥내관주유랍파미,치료과정중감측혈압、심솔,기록관주전후경로다보륵초성결과,수방6개월병진행GOS평분.결과 본조13례공실시료16근동맥내관주치료,관주전후상비교,CVS조영상개선9례,림상증상개선8례,증상무변화5례,다보륵초성검사대뇌중동맥적평균류속유치료전적(178 ±4) cm/s강지치료후적(139±4) cm/s(P＜0.05),감측심솔화평균동맥압무명현변화.소유환자수방6개월,GOS평분:회복량호10례,중도병잔단생활자리2례,중도병잔생활불능자리1례.결론 동맥내관주유랍파미치료동맥류성SAH후CVS시안전가행적,중등제량사용가유효개선CVS,동시대전신적혈류동력방면무현저영향.
Objective To study the efficacy and usage of verapamil used intraarterial infusion for vasospasm after aneurismal subarachnoid hemorrhage.Methods We treated 13 patients with cerebral vasospasm symptom after the aneurysms were handled.Cerebrovascular Angiograhy was performed,and verapamil was infusion intraarterial through catheter.During these procedures,the blood pressure,heart rate and TCD were monitored and record.The patients were followed up for 6 months.Results Intraarterial infusion treatment performed in 16 vessels of 13 patients,comparing the situation before and after infusion,vasospasm DSA improved in 9 cases,symptom improved in 8 cases,and no change in 5 cases.TCD showed that mBFVs in the middle cerebral artery decreased from(178 ±4)cm/s to(139 +4) cm/s(P ＜0.05),neither the change in heart rate nor the change in MABP was statistically significant.The follow-up (6 months after procedure) results revealed good outcome in 10 cases,mild disability in 2,severe disability in 1.Conclusions It is safety feasible to do intraarterial infusion of verapamil treatment for vasospasm after aneurismal subarachnoid hemorrh,age,and moderate dose is effective to improve cerebral vasospasm,at the same time.It does not significantly alter systemic hemodynamic.
