目的 觀察丹參注射液聯(lián)合罌粟堿防治動脈瘤術(shù)后腦血管痙攣的臨床療效。方法 選取2012年9月—2014年7月西安市第九醫(yī)院神經(jīng)外科收治的動脈瘤術(shù)后并發(fā)腦血管痙攣患者54例,隨機分為對照組和治療組,每組各27例。對照組患者肌肉注射鹽酸罌粟堿注射液,30 mg/次,3次/d。治療組靜脈滴注丹參注射液,10 mL/次,1次/d,鹽酸罌粟堿注射液的用法用量同對照組。兩組均連續(xù)治療2周。觀察兩組患者治療前后頭暈、頭痛、惡心、嘔吐、耳鳴、心慌等癥狀的出現(xiàn)例數(shù),同時比較兩組患者治療前后大腦內(nèi)動脈血流速度、腦血管痙攣范圍、腦灌注壓、中性粒細胞和單核細胞水平的變化。結(jié)果 治療1、2周,兩組患者頭暈、頭痛、惡心、嘔吐、耳鳴、心慌的例數(shù)均較治療前顯著減少,同組治療前后差異具有統(tǒng)計學(xué)意義(P< 0.05);且治療組的減少程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05)。治療后,兩組患者大腦內(nèi)動脈血流速度、腦血管痙攣范圍、腦灌注壓、中性粒細胞和單核細胞水平均較治療前顯著降低,同組治療前后差異具有統(tǒng)計學(xué)意義(P< 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05)。結(jié)論 丹參注射液聯(lián)合鹽酸罌粟堿注射液治療動脈瘤術(shù)后腦血管痙攣具有較好的臨床療效,可顯著降低腦血管痙攣范圍和腦灌注壓,具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical curative effect of Danshen Injection combined with papaverine for preventing cerebral vasospasm after aneurysm surgery. Methods Patients (54 cases) with cerebral vasospasm after aneurysm surgery in Department of Neurosurgery of Ninth Hospital of Xi'an from September 2012 to July 2014 were randomly divided into control and treatment groups, and each group had 27 cases. The patients in the control group were im administered with Papaverine Hydrochloride Injection, 30 mg/time, three times daily. The patients in the treatment group were iv administered with Danshen Injection, 10 mL/time, once daily, and the usage and dosage of Papaverine Hydrochloride Injection were the same with the control group. The patients in two groups were treated for two weeks. The numbers of dizziness, headache, nausea, vomiting, tinnitus, and palpitate in two groups before and after treatment were observed. The changes of cerebral artery blood flow velocity, cerebral vasospasm scope, cerebral perfusion pressure, neutrophils and monocytes levels in two groups before and after treatment were compared. Results Two groups of patients with dizziness, headache, nausea, vomiting, tinnitus, and palpitate were significantly reduced after 1 and 2 weeks, and the difference was statistically significant in the same group (P < 0.05). The reduced degree in the treatment group was better than that in the control group, with significant difference between two groups (P < 0.05). After treatment, cerebral artery blood flow velocity, cerebral vasospasm scope, cerebral perfusion pressure, neutrophils and monocytes levels in two groups were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observation indicators in the treatment group was better than those in the control group, and the difference was statistically significant in the same group (P < 0.05). Conclusion Danshen Injection combined with papaverine has good clinical efficacy for preventing cerebral vasospasm after aneurysm surgery, and can significantly reduce cerebral vasospasm scope and cerebral perfusion pressure, which has a certain clinical application value.