• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Minimally invasive neurosurgery: MIN >Role of intraventricular sodium nitroprusside in vasospasm secondary to aneurysmal subarachnoid haemorrhage: a 5-year prospective study with review of the literature.
【24h】

Role of intraventricular sodium nitroprusside in vasospasm secondary to aneurysmal subarachnoid haemorrhage: a 5-year prospective study with review of the literature.

机译：脑室内硝普钠在动脉瘤性蛛网膜下腔出血继发的血管痉挛中的作用：一项为期5年的前瞻性研究，并回顾了文献。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: Cerebral vasospasm remains an important cause of permanent neurological injury and death following aneurysmal subarachnoid haemorrhage, despite the best current medical therapy. Sodium nitroprusside was recently suggested as a treatment option for cerebral ischaemia in patients with severe medically refractive vasospasm after subarachnoid haemorrhage. METHODS: Twenty patients of aneurysmal SAH with severe vasospasm, corroborated on transcranial Doppler (TCD), were included in this prospective study. The neurological condition of all patients was classified as Hess and Hunt grade II or higher. The diagnosis of severe delayed cerebral vasospasm refractory to conventional treatment (HHH therapy and nimodipine) was established before treatment. Ten patients received intraventricular sodium nitroprusside (SNP), while the other 10 had either major systemic illness or did not consent, formed the control group of the study. SNP was instilled in escalating doses with a starting dose of 4 mg/mL and reversal of vasospasm was monitored on neurological examination along with TCD in a basic ICU setting without the need for neurophysiological or invasive monitoring. RESULTS: All patients in the study group showed an improvement in TCD velocities post-SNP instillation. Adverse effects were vomiting and hypotension in the SNP group which responded to medical management. The overall neurological outcome was good or excellent in 7/10 patients in the SNP group. Comparison between the two groups revealed improvement in TCD velocities and GCS in the SNP group thus affecting the long-term prognosis. CONCLUSION: Intraventricular sodium nitroprusside represents a promising method of treatment for established delayed cerebral vasospasm and cerebral ischaemia refractory to conventional treatment.
机译：目的：尽管目前药物治疗效果最好，但脑血管痉挛仍是导致动脉瘤性蛛网膜下腔出血后永久性神经损伤和死亡的重要原因。最近有人建议将硝普钠作为蛛网膜下腔出血后严重的医学屈光性血管痉挛患者的脑缺血治疗方法。方法：本研究纳入了经颅多普勒（TCD）确诊的20例严重血管痉挛性动脉瘤SAH患者。所有患者的神经系统疾病分类为Hess和Hunt二级或更高。在治疗前已确定对常规治疗（HHH治疗和尼莫地平）难治的严重迟发性脑血管痉挛的诊断。 10例患者接受了脑室内硝普钠（SNP）治疗，而其他10例患有严重的全身疾病或不同意，构成了研究的对照组。以递增剂量滴注SNP，起始剂量为4 mg / mL，并在基本ICU设置下通过神经系统检查和TCD监测血管痉挛的逆转，而无需进行神经生理学或侵入性监测。结果：研究组中的所有患者在SNP滴注后均显示出TCD速度的改善。 SNP组的不良反应是呕吐和低血压，对药物治疗有反应。在SNP组中，有7/10名患者的总体神经功能预后良好。两组之间的比较显示SNP组的TCD速度和GCS有所改善，从而影响了长期预后。结论：脑室内硝普钠代表了一种有前途的治疗方法，该方法可治疗传统治疗难以治疗的延迟性脑血管痉挛和脑缺血。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号