CAJ | 학술논문

目的：探讨尼莫地平对外伤性蛛网膜下腔出血的临床疗效，为临床诊治提供参考。方法收集南昌大学医学院一附：（进修期间）2014年1~8月收治的160例外伤性蛛网膜下腔出血患者，分为治疗组和对照组，各80例。对照组给予常规治疗，治疗组在对照组治疗基础上给予尼莫地平注射液治疗，动态监测并记录两组患者治疗前和治疗后3、7、14 d的GCS评分、颅内压和MCA流速，所有患者随访3个月，按GOS方法评估不良预后发生率。结果治疗后第7、14天，治疗组GCS评分高于对照组，颅内压低于对照组，两组差异有统计学意义（P<0.05）；治疗后第3、7、14天，治疗组MCA流速低于对照组，两组差异有统计学意义（P<0.05）。随访3个月，无失访病例，治疗组良好恢复率高于对照组（61.2% vs 42.5%），两组差异有统计学意义（P<0.05）。结论早期应用尼莫地平可明显减少CVS的发生，促进患者病情恢复，改善其预后，值得临床推广应用。
목적：탐토니막지평대외상성주망막하강출혈적림상료효，위림상진치제공삼고。방법수집남창대학의학원일부：（진수기간）2014년1~8월수치적160예외상성주망막하강출혈환자，분위치료조화대조조，각80례。대조조급여상규치료，치료조재대조조치료기출상급여니막지평주사액치료，동태감측병기록량조환자치료전화치료후3、7、14 d적GCS평분、로내압화MCA류속，소유환자수방3개월，안GOS방법평고불량예후발생솔。결과치료후제7、14천，치료조GCS평분고우대조조，로내압저우대조조，량조차이유통계학의의（P<0.05）；치료후제3、7、14천，치료조MCA류속저우대조조，량조차이유통계학의의（P<0.05）。수방3개월，무실방병례，치료조량호회복솔고우대조조（61.2% vs 42.5%），량조차이유통계학의의（P<0.05）。결론조기응용니막지평가명현감소CVS적발생，촉진환자병정회복，개선기예후，치득림상추엄응용。
Objective To evaluate the clinical curative effect of nimodipine for traumatic subarachnoid hemorrhage to provide reference for clinical diagnosis and treatment. Methods 160 patients with traumatic subarachnoid hemorrhage treated in the First Affiliated Hospital of Medical School of Nanchang University from January 2014 to August 2014 were collected.Patients were divided into treatment group (n=80) and control group (n=80).Control group received con-ventional therapy and treatment group received nimodipine injection treatment on the basis of conventional therapy.GCS score,intracranial pressure and MCA flow velocity before treatment,and after 3,7,14 days treatment in patients of two groups was dynamically monitored and recorded respectively.All patients were followed up for three months,the inci-dence rate of bad prognosis was assessed according to the GOS score method. Results After 7,14 days treatment,GCS score in treatment group was significantly higher than that of control group,and intracranial pressure was lower than that of control group,the difference was statistically significant (P<0.05).After 3,7,14 days treatment,MCA flow rate of treat-ment group was lower than that of control group,the difference was statistically significant (P<0.05).Patients were fol-lowed up for 3 months,no cases were lost,the rate of good recovery in treatment group was significantly higher than that of control group (61.2%v s 42.5%,P<0.05). Conclusion Early application of nimodipine can significantly reduce the in-cidence of CVS,promote recovery of the disease and improve prognosis in patients,and it is worthy of clinical promotion and application.