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目的探讨尼莫地平治疗高血压性脑出血破入脑室的疗效和作用机制。方法用尼莫地平治疗高血压性脑出血破入脑室患者,比较治疗组与对照组的脑循环动力学参数、治疗有效率、头颅 CT 片上的血肿量和水肿面积大小。结果治疗组用药后脑循环动力学参数中的平均血流速度(Vmean)、平均血流量(Qmean)值较对照组用药后有明显的增高(P<0.05),外周血管阻力(R)、临界压力(CP)较对照组明显下降(P<0.01),其中 Vmean、Qmean、R 与 CP 值在治疗组治疗后双侧无明显差异;治疗组的治疗好转例数明显较对照组高;治疗组治疗前后的水肿面积积分差、血肿量积分差与对照组没有明显差异。结论尼莫地平治疗高血压性脑出血破入脑室者具有增加脑血流量、降低脑血管阻力、调节脑血管功能、减少可能的广泛脑血管痉挛、提高近期治疗效果作用,但对血肿量和水肿面积无作用。
Objective To investigate the efficacy and mechanism of nimodipine in treating hypertensive intracerebral hemorrhage (ICH). Methods Nimodipine was used to treat hypertensive intracerebral hemorrhage in patients with cerebral hemorrhage. The cerebral circulation kinetic parameters, the therapeutic efficiency, the hematoma volume and the area of edema on the head CT were compared between the treatment group and the control group. Results The mean blood flow velocity (Vmean) and Qmean of the cerebral circulation kinetics parameters in the treatment group were significantly higher than those in the control group (P <0.05), while the peripheral vascular resistance (R), critical pressure (P <0.01). The Vmean, Qmean, R and CP values in the treatment group were not significantly different on both sides after treatment; the treatment group’s treatment improved number significantly higher than the control group; treatment group treatment Before and after the edema area integral difference, hematoma integral difference with the control group no significant difference. Conclusion Nimodipine treatment of hypertensive intracerebral hemorrhage in patients with cerebral hemorrhage have increased cerebral blood flow, reduce cerebral vascular resistance, regulate cerebrovascular function, reduce the possible extensive cerebral vasospasm and improve the effect of short-term treatment, but the amount of hematoma and edema Area no effect.