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蛛网膜下腔出血后动脉内注射盐酸法舒地尔治疗血管痉挛:90例经验

Intra-arterial Administration of Fasudil Hydrochloride for Vasospasm Following Subarachnoid Haemorrhage: Experience of 90 Cases.

作者信息

Iwabuchi S, Yokouchi T, Hayashi M, Sato K, Saito N, Hirata Y, Harashina J, Nakayama H, Akahata M, Ito K, Kimura H, Aoki K

机构信息

Department of Neurosurgery, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.

出版信息

Acta Neurochir Suppl. 2011;110(Pt 2):179-81. doi: 10.1007/978-3-7091-0356-2_33.

Abstract

BACKGROUND

we investigated the clinical efficacy of intra-arterial administration of fasudil hydrochloride for cerebral vasospasm.

METHOD

we reviewed 90 cases treated with intra-arterial administration of fasudil hydrochloride between August 1998 and April 2009 and investigated the clinical efficacy for cerebral vasospasm.

FINDINGS

angiographic improvement of vasospasm was noted in all procedures. Eight had ischemic lesion on CT at discharge in Group A, which included 39 patients who presented angiographic and symptomatic vasospasm. However, 4 (50%) of these eight were recovered with a condition of GR. No patients showed ischemic lesion on CT in Group B, which included 51 patients who presented angiographic vasospasm without symptoms. Two (3.3%) of 59 patients who presented angiographic vasospasm without symptoms at the initial follow-up angiography had ischemic lesion on CT at discharge. The 1-year follow-up showed 78.9% of GR. No patient showed any adverse effects resulting from intra-arterial administration of fasudil hydrochloride.

CONCLUSION

intra-arterial administration of fasudil hydrochloride was an effective and safe management technique for vasospasm.

摘要

背景

我们研究了动脉内注射盐酸法舒地尔治疗脑血管痉挛的临床疗效。

方法

我们回顾了1998年8月至2009年4月间接受动脉内注射盐酸法舒地尔治疗的90例患者,并研究了其治疗脑血管痉挛的临床疗效。

结果

所有操作中血管痉挛的血管造影均有改善。A组39例出现血管造影和症状性血管痉挛的患者中,8例出院时CT显示有缺血性病变。然而,这8例中有4例(50%)恢复至良好恢复状态。B组51例出现血管造影性血管痉挛但无症状的患者中,出院时CT均未显示缺血性病变。在初次随访血管造影时出现血管造影性血管痉挛但无症状的59例患者中,2例(3.3%)出院时CT显示有缺血性病变。1年随访显示良好恢复率为78.9%。动脉内注射盐酸法舒地尔未导致任何患者出现不良反应。

结论

动脉内注射盐酸法舒地尔是治疗血管痉挛的一种有效且安全的管理技术。

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