维拉帕米联合硝酸甘油对神经介入 术中血管痉挛的效果观察
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高有安,男,副主任医师,主要研究方向是神经内科方面。

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R 743

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Effect of Verapamil Combined with Nitroglycerin on Vasospasm During Neural Interventional Surgery
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    摘要:

    摘 要目的:探讨维拉帕米联合硝酸甘油对动脉血管内灌注治疗神经介入治疗术中脑血管痉挛的效果。 方法:选取 2020 年 1 月至 2021 年 4 月在东莞市滨海湾中心医院接受神经介入治疗(急诊+择期),且术中出现血管痉挛的 23 例患者, 随机分为对照组(11 例)和观察组(12 例)。观察组采用维拉帕米联合硝酸甘油灌注治疗,对照组采用灌注罂粟碱;观察 两组患者在血管痉挛缓解的时间和程度上的差别,同时评价维拉帕米联合硝酸甘油用药过程中的安全性。 结果:观察组患 者血管痉挛在 5 min 内缓解率为 83.3 %,显著高于对照组的 27.3 %,差异具有统计学意义(P < 0.05)。两组患者治疗前 后生命体征变化均无统计学意义(P > 0.05)。 结论:动脉血管内灌注维拉帕米联合硝酸甘油的方法可快速有效解除脑血 管痉挛,缩短手术时间,在手术时间节点方面有优势,该方法缓解血管痉挛起效快、疗效持久稳定,安全性高。

    Abstract:

    AbstractObjective To investigate the effect of verapamil combined with intra-arterial infusion of nitroglycerin in the treatment of cerebral vasospasm during neurointerventional therapy. Methods From January 2020 to April 2021, 23 patients who received neurointerventional therapy (emergency + elective) at Dongguan Binhaiwan Central Hospital and had vasospasm during the operation were selected and randomly divided into control group (11 cases) and observation group (12 cases). The observation group was treated with verapamil combined with nitroglycerin perfusion, and the control group was treated with papaverine perfusion. The differences in the time and degree of vasospasm relief between the two groups were observed, and the safety of verapamil combined with nitroglycerin was evaluated. Results The remission rate of vasospasm in the observation group was 83.3% within 5 minutes, which was significantly higher than 27.3% in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in vital signs before and after treatment in the two groups (P > 0.05). Conclusion The method of intra-arterial infusion of verapamil combined with nitroglycerin can quickly and effectively relieve cerebral vasospasm, shorten the operation time, and has advantages in quality control of the operation time node. This method was quickly effective, long-lasting and stable as well as highly safe in relieving vasospasm.

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  • 收稿日期:2021-09-23
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  • 在线发布日期: 2023-06-29
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