摘要
目的 探索脑室出血后脑血管痉挛（CVS）的存在及其影响。方法 选取CVS患者176例,分为常规治疗组和抗痉挛组,所有患者按照脑室出血诊疗指南治疗,抗痉挛组在常规治疗基础上加用抗痉挛治疗。所有患者第5-7、10、14天做经颅多普勒（TCD）检查了解脑血流情况,计算血管痉挛指数,第5、14天所有患者做MRI灌注成像测定脑血容量判断有无脑缺血,并评估CVS及其影响。结果 脑室出血后,所有患者均存在脑血管痉挛,随着时间推移,痉挛指数不断增大,提示痉挛加重。抗痉挛组各时间段痉挛指数均低于常规治疗组（P〈0.05）。抗痉挛组灌注参数明显高于常规治疗组（P〈0.05）。所有患者随访3个月后发现,抗痉挛组的预后明显优于常规治疗组（P〈0.05）。结论 脑室出血后,通过抗血管痉挛治疗,可以更好的改善预后。
Objective To explore the existence and influence of cerebral vasospasm（CVS） after ventricular hemorrhage. Methods Totally 176 patients with CVS were divided into the convennonal therapy group and antispasmodic group. All patients were treated according to the guidelines of diagnose and therapy for ventricular hemorrhage. The antispasmodic group was added with antispasmodic therapy on the basis of the conventional treatment. The transcranial Doppler（TCD） sonography was performed in all the cases on 5-7,10,14 d for understanding the cerebral blood flow situation. The vascular spasm index（VSI） was calculat- ed. All cases were performed the MR perfusion weighted image（MR-PWI）on 5,14 d for determining cerebral blood volume and jud- ging cerebral ischemia. Then CVS and its influence were evaluated. Results Cerebral vasospasm after ventricular hemorrhage exis- ted in all cases. VSI was gradually increased with time elapse, which indicating that spasm was aggravated. VSI at various time peri- ods in the antispasmodic group was lower than that in the conventional therapy group（P〈0.05）. The perfusion parameters in the antispasmodic group were significantly higher than those in the conventional therapy group （P〈0.05）. The 3-month follow up found that the prognosis in the antispasmodic group was better than that in the conventional therapy group（P〈0.05 ）. Conclusion The anti-vasospasm therapy after cerebral ventricular hemorrhage can better improve tke prognosis.
出处
《重庆医学》
CAS
北大核心
2016年第32期4505-4506,4510,共3页
Chongqing medicine
基金
重庆市卫生和计划生育委员会面上项目(20142231)
关键词
脑室出血
脑血管痉挛
脑灌注
脑缺血
ventricular hemorrhage
cerebral vasospasm
cerebral perfusion
cerebral ischemia
