尼莫地平治疗动脉瘤性蛛网膜下腔出血的经验。
Experience with nimodipine in aneurysmal subarachnoid haemorrhage.
作者信息
Popovic E A, Danks R A, Siu K H
机构信息
Monash Medical Centre, Prince Henry's Hospital Campus, Melbourne, Vic.
出版信息
Med J Aust. 1993 Jan 18;158(2):91-4. doi: 10.5694/j.1326-5377.1993.tb137531.x.
OBJECTIVES
To assess the efficacy of nimodipine in preventing delayed ischaemic deficit in aneurysmal subarachnoid haemorrhage.
DESIGN
A continuous prospective audit of all patients with aneurysmal subarachnoid haemorrhage admitted to the joint neurosurgery units of Prince Henry's and Alfred hospitals, Melbourne. Patients were divided into two groups--135 in the pre-nimodipine group during 1986 to 1989, and 73 in the nimodipine group during 1989 and 1990.
MAIN OUTCOME MEASURES
Outcome was measured according to the Glasgow outcome scale and the incidence of delayed ischaemic deficit was recorded.
RESULTS
A substantial reduction in the overall incidence of poor outcome was observed, from 37% of patients in the non-nimodipine group, to 20% in the nimodipine group (P = 0.022). Delayed ischaemic deficit occurred in 41% and 21% (P = 0.005), and poor outcome due to delayed ischaemic deficit occurred in 18% and 8% (P = 0.09) respectively.
CONCLUSIONS
In our experience, nimodipine appears to have substantially reduced the incidence of delayed ischaemic deficits in patients with aneurysmal subarachnoid haemorrhage, with a resultant improvement in overall patient outcome.
目的
评估尼莫地平预防动脉瘤性蛛网膜下腔出血后迟发性缺血性神经功能缺损的疗效。
设计
对墨尔本亨利王子医院和阿尔弗雷德医院联合神经外科收治的所有动脉瘤性蛛网膜下腔出血患者进行连续前瞻性审计。患者分为两组——1986年至1989年期间的135例患者纳入尼莫地平治疗前组，1989年和1990年期间的73例患者纳入尼莫地平组。
主要观察指标
根据格拉斯哥预后量表评估预后，并记录迟发性缺血性神经功能缺损的发生率。
结果
观察到预后不良的总体发生率大幅降低，从非尼莫地平组的37%降至尼莫地平组的20%（P = 0.022）。迟发性缺血性神经功能缺损的发生率分别为41%和21%（P = 0.005），因迟发性缺血性神经功能缺损导致的预后不良发生率分别为18%和8%（P = 0.09）。
结论
根据我们的经验，尼莫地平似乎显著降低了动脉瘤性蛛网膜下腔出血患者迟发性缺血性神经功能缺损的发生率，从而改善了患者的总体预后。
Zotero 插件