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口服和颅内尼莫地平给药在蛛网膜下腔出血后的结果-单中心研究。

Outcome of Oral and Intra-arterial Nimodipine Administration After Aneurysmal Subarachnoid Haemorrhage - A Single-centre Study.

机构信息

Department of Neurosurgery, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

Department of Anaesthesiology and Surgical Intensive Care Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

出版信息

In Vivo. 2019 Nov-Dec;33(6):1967-1975. doi: 10.21873/invivo.11692.

Abstract

BACKGROUND

Oral nimodipine is administered to improve clinical outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). In this study, clinical outcome in patients with and without oral nimodipine administration was assessed.

MATERIALS AND METHODS

A total of 105 patients did not receive oral nimodipine but did receive intra-arterial nimodipine in the occurrence of hemodynamically relevant vasospasm after aSAH, whereas 74 patients received applications of both. Demographic/radiological details and clinical presentation were abstracted from the case records.

RESULTS

Patient baseline characteristics were comparable, a predominance of endovascular coiling was shown in cohort 2 (p=0.0135). Severity of initial aSAH and clinical status at admission (Hunt and Hess) was significantly higher in those receiving oral nimodipine. Incidence of angiographic vasospasm was significantly higher in patients not treated with oral nimodipine (p=0.0305); a significantly better outcome measured by the National Institute of Health Stroke Scale (p=0.0213), was noted in those receiving oral nimodipine.

CONCLUSION

Oral nimodipine administration improved clinical outcome of patients after aSAH and should be administered routinely for such patients.

摘要

背景

口服尼莫地平可改善蛛网膜下腔出血(aSAH)患者的临床预后。本研究评估了接受和未接受口服尼莫地平治疗的患者的临床预后。

材料与方法

共有 105 例患者未接受口服尼莫地平治疗,但在 aSAH 后出现与血流动力学相关的血管痉挛时接受了动脉内尼莫地平治疗,而 74 例患者同时接受了这两种治疗。从病历中提取人口统计学/影像学细节和临床表现。

结果

患者基线特征无差异,第 2 组(p=0.0135)以血管内介入治疗为主。接受口服尼莫地平治疗的患者初始蛛网膜下腔出血严重程度和入院时的临床状况(Hunt 和 Hess)显著更高。未接受口服尼莫地平治疗的患者血管造影血管痉挛的发生率显著更高(p=0.0305);接受口服尼莫地平治疗的患者的国立卫生研究院卒中量表评分(p=0.0213)显著更好。

结论

口服尼莫地平治疗可改善 aSAH 患者的临床预后,应常规用于此类患者。

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本文引用的文献

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The Barrow Ruptured Aneurysm Trial.巴罗破裂动脉瘤试验。
J Neurosurg. 2012 Jan;116(1):135-44. doi: 10.3171/2011.8.JNS101767. Epub 2011 Nov 4.
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Calcium antagonists for aneurysmal subarachnoid haemorrhage.用于动脉瘤性蛛网膜下腔出血的钙拮抗剂。
Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD000277. doi: 10.1002/14651858.CD000277.pub3.
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Subarachnoid haemorrhage.蛛网膜下腔出血
Lancet. 2007 Jan 27;369(9558):306-18. doi: 10.1016/S0140-6736(07)60153-6.
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Predictors of cerebral infarction in aneurysmal subarachnoid hemorrhage.动脉瘤性蛛网膜下腔出血后脑梗死的预测因素
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