CAJ | 학술논문

目的：探讨尼莫地平与依达拉奉对动脉瘤性SAH及行夹闭或栓塞术后患者的脑血管痉挛预防和治疗，并评价这两种药物的临床疗效作用。方法收集动脉瘤自发性SAH行动脉瘤夹闭或介入栓塞术后患者76例，其中38例入院后使用尼莫地平防治脑血管痉挛，另38例入院后在常规治疗基础上加用依达拉奉防治脑血管痉挛，观察两组患者14 d后临床有效例数、发生脑血管痉挛( CVS)例数、发生迟发性脑缺血( DCI)例数及死亡例数，根据神经功能缺损程度评分减少的幅度判断临床疗效。结果治疗14 d内，治疗组与对照组临床有效率、CVS发生率、DCI发生率及死亡率差异具有统计学意义。结论早期应用依达拉奉可进一步提高患者术后的神经功能恢复，降低CVS及DCI的发生率，其效果优于尼莫地平。
목적：탐토니막지평여의체랍봉대동맥류성SAH급행협폐혹전새술후환자적뇌혈관경련예방화치료，병평개저량충약물적림상료효작용。방법수집동맥류자발성SAH행동맥류협폐혹개입전새술후환자76례，기중38례입원후사용니막지평방치뇌혈관경련，령38례입원후재상규치료기출상가용의체랍봉방치뇌혈관경련，관찰량조환자14 d후림상유효례수、발생뇌혈관경련( CVS)례수、발생지발성뇌결혈( DCI)례수급사망례수，근거신경공능결손정도평분감소적폭도판단림상료효。결과치료14 d내，치료조여대조조림상유효솔、CVS발생솔、DCI발생솔급사망솔차이구유통계학의의。결론조기응용의체랍봉가진일보제고환자술후적신경공능회복，강저CVS급DCI적발생솔，기효과우우니막지평。
Objective To investigate the effects of nimodipine and edaravone for the prevention and treatment of cerebral angiospasm in the patients with aneurysm SAH underwent aneurysm occlusion and embolization. And to evaluate the clinical efficacy of two kinds of medicines. Method A total of 76 patients with aneurysm spontaneous SAH who were performed with aneurysm occlusion or embolization were enrolled in this study. Among them,38 cases were given nimodipine to prevent and cure cerebral angiospasm after being hospitalized. Other 38 cases were administrated with edaravone based on conventional therapy. The clinical effective number, incidence of CVS,DCI and death were observed and recorded after 14 days. Meanwhile,the clinical efficacy of the treatment was estimated according to the reducing degree of NIHSS. Results After 14 days, there were statistical differences in clinical effective number,incidence of CVS,DCI and death rate between two groups ( P<0 . 05 ) . Conclusion Edaravone plays remarkable role in preventing and curing cerebral angiospasm and delayed cerebral ischemia. Edaravone could reduce incidence of CVS and DCI, further if it was used in early stage,which effect is better than nimodipine.