Therapeutic effect of different administration routes of nimodipine on cranio-cerebral trauma with subarachoid hemorrhage

YAN Wei-wei; TONG Xiao-guang; DU Yi

doi:10.3760/cma.j.issn.1673-4777.2012.06.016

Abstract：Objective To observe the therapeutic effect of different administration routes of nimodipine in treatment of cranio-cerebral trauma with subarachoid hemorrhage.Methods All 80 patients with cerebral injury complicated by subarachoid hemorrhage [ glasgow coma scale(GCS) 6-12] were randomly divided into control group,oral administration group( for 14 days),intravenous injection group( by micro-pump for 14 days) and perfused group( perfused in operation and then injected).Intracranial pressure,GCS and contraction peak flow velocity of middle cerebral artery were closely observed,and glasgow outcome scale (GOS),complication were measured 3 months later.Results The proportion of cerebral vasospasm[ 25.0 (5/20) vs 70.0％ (14/20),55.0％ (11/20),35.0％ (7/20) ] and the rate of unfavourable prognosis [ 30.0％ ( 6/20 ) vs 50.0％ ( 10/20 ),40.0％ ( 8/20 ),35.0％ (7/20) ] in perfused group were significantly lower than those in the other three groups( all P ＜ 0.05).The contraction peak flow velocity of middle cerebral artery at 1 week,2 week,3 week after operation in perfused group were less than those in the other three groups (all P ＜ 0.05).The intracranial pressure in one week after operation in four groups showed the trends of rising first,and then decreasing.At 21 th day after operation,compared to the first day postoperation,the GCS score in four groups increased( all P ＜ 0.05 ).The ratio of patients of unfavourahle prognosis in perfused group significantly less than those in control group and oral administration group[30.0％ (6/20) vs 50.0％ (10/20) 、40.0％ ( 8/20 ),P ＜ 0.05 ].Conclusion Nimodipine perfusing in operation can decrease the proportion of cerebral vasospasm and has a therapeuric effect on subarachoid hemorrhage in the early stage of craniocerebral trauma.