CAJ | 학술논문

目的：对比分析地尔硫卓和尼莫通在颅内动脉狭窄支架置入术中、术后预防和治疗血管痉挛以及对血压调控的疗效。方法：选择2013年3月至2014年12月间经全脑血管造影后明确颅内动脉狭窄的缺血性脑血管病，需进行支架置入术治疗的患者84例，按照随机分配的原则分为地尔硫卓组和尼莫通组，术中及术后24 h给予上述两种药物微量泵入，术中若出现血管痉挛，地尔硫卓组给予微导管注射地尔硫卓缓解痉挛，而尼莫通组则加大尼莫通泵入量，若术中出现血压升高，地尔硫卓组给予静脉注射地尔硫卓，尼莫通组给予加大尼莫通泵入量。记录两组药物对于血管痉挛的预防效果，以及出现血管痉挛后的治疗效果及痉挛缓解的时间，出现血压升高后，两组的降压效果及血压下降的时间，以及药物的不良反应。术前始至术后24 h给予持续心电、血压、血氧监测。结果：两组患者在预防血管痉挛方面差异无统计学意义，但在术中出现血管痉挛及血压升高时，地尔硫卓组在解除血管痉挛及降压效果及时间方面优于尼莫通组。结论：地尔硫卓可用于颅内动脉狭窄支架置入术中及术后预防血管痉挛。地尔硫卓在术中解除血管痉挛及迅速控制血压方面疗效优于尼莫通组。
목적：대비분석지이류탁화니막통재로내동맥협착지가치입술중、술후예방화치료혈관경련이급대혈압조공적료효。방법：선택2013년3월지2014년12월간경전뇌혈관조영후명학로내동맥협착적결혈성뇌혈관병，수진행지가치입술치료적환자84례，안조수궤분배적원칙분위지이류탁조화니막통조，술중급술후24 h급여상술량충약물미량빙입，술중약출현혈관경련，지이류탁조급여미도관주사지이류탁완해경련，이니막통조칙가대니막통빙입량，약술중출현혈압승고，지이류탁조급여정맥주사지이류탁，니막통조급여가대니막통빙입량。기록량조약물대우혈관경련적예방효과，이급출현혈관경련후적치료효과급경련완해적시간，출현혈압승고후，량조적강압효과급혈압하강적시간，이급약물적불량반응。술전시지술후24 h급여지속심전、혈압、혈양감측。결과：량조환자재예방혈관경련방면차이무통계학의의，단재술중출현혈관경련급혈압승고시，지이류탁조재해제혈관경련급강압효과급시간방면우우니막통조。결론：지이류탁가용우로내동맥협착지가치입술중급술후예방혈관경련。지이류탁재술중해제혈관경련급신속공제혈압방면료효우우니막통조。
Objective:To comparatively analyze the efficacy of Diltiazem and Nimodipine in the prevention and treatment of vasospasm in stent implantation for intracranial artery stenosis during and after the operation , and in the regulation on blood pressure .Method:Intracranial artery ste-nosis patients with ischemic cerebrovascular disease verified by cerebral angiography were consecutively reviewed from March 2013 to March 2014. Among all of them, 84 patients who had the necessity to be given the treatment of stent implantation were randomly assigned into the Diltiazem group and the Nimotop group, with the above two drugs pumped in micro amount during intraoperative and postoperative period (within 24 hours). If vasospasm occurred during operation, diltiazem from microcatheter was given to relieve spasm in Diltiazem group , while Nimotop was pumped in increasing amount in the Nimotop group .If blood pressure elevated during operation , Diltiazem through intravenous injection was given in the Dilti-azem group, while the treatment in the Nimotop group was the same as that for vasospasm .Preventive effect and the treatment effect on vasospasm , the remission time for vasospasm , antihypertensive effect and the time of blood pressure drop after higher blood pressure , and adverse drug reactions of the drugs in the two groups were recorded.Before and after operation (within 24 hours) ECG, blood pressure and blood oxygen were continuous-ly monitored.There was no significantly statistical difference between the two groups in the prevention of vasospasm, but when intraopera-tive vasospasm and elevated blood pressure occurred, Diltiazem group was superior to Nimotop group in relieving vasospasm, antihyper-tensive effect and the remission time.Conclusions:Diltiazem can be applied to stent implantation for intracranial artery stenosis for the preven-tion of intraoperative and postoperative vasospasm .The efficacy of Diltiazem is superior to that of Nimotop in relieving vasospasm and the rapid con-trol of blood pressure during operation.