| Objective:To investigate effect of combined nimodipine and fasudil hydrochloride treatmenting cerebral vasospasm(CVS)after intracranial aneurysm surgery. Cerebral vasospasm after intracranial aneurysm surgery is a common severe complication,and also a major reason of death and disability postoperative. With the medical theories and clinical technology continuing to evolve, the survival rate of patients is greatly improved after intracranial aneurysm surgery, prognosis and quality of life has been greatly improved. However, postoperative of intracranial aneurysms, CVS has not been idealy controlled and treatment. Therefore, the study of treatment for cerebral vasospasm after intracranial aneurysms surgery, having made new treatment options, is still a very necessary question.Methods:Collection of 48 patients with intracranial aneurysms,which passing microsurgery surgical clipping or endovascular treatment,from the First Affiliated Hospital of Dalian Medical University, Neurosurgery, from July 2009 to January 2010.A randomized, with positive drug nimodipine as the control method, was divided into nimodipine and fasudil hydrochloride group (after, referred to as the combination group) and the nimodipine group alone,24 patients in each group, analysis of the clinical data of 48 patients after intracranial aneurysm treatment.Treatment:the combination group:FSD 30mg + NS 100ml intravenously q12h,while giving 100ml nimodipine 4ml/h,(10mg/100ml)continuouing intravenous infusion in 24 hours, Nimodipine group:nimodipine alone 4ml/h,continuouing intravenous infusion in 24 hours.Both groups were continuous medication for 2 weeks. Two groups were compared after treatment DSA, TCD, CT results, medic-ation changes and prognosis during the blood pressure pulse rate changes and Changes in outcome scores.Results:The patients significantly improved conditions, can effec-tively relieve CVS of patients after intracranial aneurysm surgery, can significantly improve the prognosis of patients.Clinical analysis of the two groups showed no significant difference between the overall effect (P> 0.05):as follows(1) TCD examination:Before treatment and7,14days after treatment,the MCA mean velocity were:combination group(Agroup):96.95±4.17,87.38±4.14,82.85±3.21;nimodipinegroup(Bgroup):95.00±4.00,85.67±3.97,81.82±2.97.(p=0.726,p=0.566,p=0.993>0.05),nosignificant difference between the two groups; (2) DSA examination:the 7 days after treatment, DSA examination revealed significant CVS (combination group,13 cases, 16 cases of nimodipine). There were all no significant CVS after treatment 14 days. No significant difference between the two groups. (3) CT:head CT examination before treatment without cerebral infarction,7days after treatmen,found new cerebral infarct (combined group 5 cases, nimodipine group 6 cases), the treatment groups after 14 days, no new cerebral infarct patients.(4) outcome score:According to the Fourth National Cerebrovascul ar Disease Conference in stroke patients through clinical neurological impairment scores. The results showed:7days after treatment:A group was 79.17%, B group 75.00%, no significant difference between the two groups (P>0.05); 14days, A group was 95.83%, B group 91.67%, which showed no significant difference (P>0.05); (5) Both groups were small impact of blood pressure and pulse on the overall treatment process and treatment finished, individual fluctuations disappeared after adjustments of treatment, the overall difference was not statistically significant (p>0.05).(6) adverse reactions and safety:two mild adverse reactions, the difference was not statistically significant (p> 0.05).Conclusion:The clinical trial results show that the combination of nimodipine and fasudil and nimodipine alone are effective on the prevention and treatment of CVS after intracranial aneurysm surgery, but the experimental method selected two drugs, the clinical efficacy difference was not statistically significant. |
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