目的 观察丹参注射液联合罂粟碱防治动脉瘤术后脑血管痉挛的临床疗效。方法 选取2012年9月—2014年7月西安市第九医院神经外科收治的动脉瘤术后并发脑血管痉挛患者54例,随机分为对照组和治疗组,每组各27例。对照组患者肌肉注射盐酸罂粟碱注射液,30 mg/次,3次/d。治疗组静脉滴注丹参注射液,10 mL/次,1次/d,盐酸罂粟碱注射液的用法用量同对照组。两组均连续治疗2周。观察两组患者治疗前后头晕、头痛、恶心、呕吐、耳鸣、心慌等症状的出现例数,同时比较两组患者治疗前后大脑内动脉血流速度、脑血管痉挛范围、脑灌注压、中性粒细胞和单核细胞水平的变化。结果 治疗1、2周,两组患者头晕、头痛、恶心、呕吐、耳鸣、心慌的例数均较治疗前显著减少,同组治疗前后差异具有统计学意义(P< 0.05);且治疗组的减少程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。治疗后,两组患者大脑内动脉血流速度、脑血管痉挛范围、脑灌注压、中性粒细胞和单核细胞水平均较治疗前显著降低,同组治疗前后差异具有统计学意义(P< 0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。结论 丹参注射液联合盐酸罂粟碱注射液治疗动脉瘤术后脑血管痉挛具有较好的临床疗效,可显著降低脑血管痉挛范围和脑灌注压,具有一定的临床推广应用价值。

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.