目的 探讨双靶点微创联合尼莫地平治疗丘脑出血破入脑室患者的安全性及对NIHSS评分的影响。方法 选择2017年1月—2020年1月期间本院收治的54例丘脑出血破入脑室患者作为研究资料,随机分组各27例,对照组行单纯侧脑室体外引流术治疗,观察组行立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗,均实施尼莫地平治疗,观察两组手术并发症,测定治疗不同阶段患者NIHSS评分、ADL评分、神经损伤指标、创伤应激指标变化。结果 并发症率比较,观察组7.41%低于对照组29.63%,P＜0.05;治疗后,观察组NSE、NGF、β-EP、Cor均降低,且低于对照组,P＜0.05;治疗后,观察组NIHSSL评分降低且低于对照组,ADL评分升高且高于对照组,P＜0.05。结论 针对丘脑出血破入脑室患者采取立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术及尼莫地平治疗可进一步改善神经功能及生活质量,且手术安全性高,创伤应激恢复改善,神经损伤恢复快,并发症少,值得推广。

Objective To investigate the safety of double target minimally invasive surgery combined with nimodipine in the treatment of patients with thalamic hemorrhage breaking into ventricle and its influence on NIHSS score. Methods From January 2017 to January 2020, 54 patients with thalamic hemorrhage ruptured into ventricles in our hospital were selected as the research data, and they were randomly divided into 27 cases in each group. The control group was treated with external drainage of lateral ventricle alone, and the observation group was treated with stereotactic double target minimally invasive puncture and drainage of hypothalamic hematoma. The changes of NIHSS score, ADL score, nerve injury index and trauma stress index in different stages of treatment were determined. Results The complication rate of the observation group was 7.41%, lower than that of the control group 29.63%, P<0.05; after treatment, NSE, NGF, β-EP, Cor in the observation group were decreased, and lower than those in the control group, P<0.05; after treatment, NIHSSL score of the observation group was decreased, lower than that of the control group, ADL score was increased and higher than that of the control group, P<0.05. Conclusion For patients with thalamic hemorrhage breaking into ventricles, stereotactic double target minimally invasive puncture drainage combined with thalamic hematoma and nimodipine treatment may further improve the neurological function and patients’ quality of life, and the operation safety is high, the recovery of traumatic stress is improved, the recovery of nerve injury is quick, and the complications are less, which is worthy of promotion.

目的 探讨尼莫地平对无症状脑梗塞认知功能障碍的改善作用及安全性。方法 将80例无症状脑梗塞患者随机分为治疗组和对照组,每组40例,于治疗前及治疗后3月分别进行蒙特利尔认知量表(MoCA)、简易智能状态量表(MMSE)、画钟测验(CDT)评估,并比较2组的评分结果。结果 尼莫地平治疗后3月MMSE 评分为(26.35±3.26)分,MoCA评分为(25.53±4.31)分,CDT评分为(6.12±2.23)分,较对照组分别为MMSE 评分为(23.12±3.45)分,MoCA评分为(22.21±3.63)分,CDT评分为(4.35±2.61)分有改善,差异均有统计学意义(P<0.05)。80例患者中MoCA评测异常组在视空间与执行能力、延迟记忆、注意力及计算力、抽象思维等分项得分明显低于MoCA评测正常组(P<0.05)。结论 尼莫地平能有效改善无症状脑梗塞患者的认知功能,且安全性较高。

Objective To explore the role of nimodipine in improving cognitive function in silent cerebral infarction patients and its safety. Methods Eighty SCI patients were divided randomly into 2 groups.MMSE、MoCA and CDT scores were assessed before treatement and after 3 month of treatment.The results were compared between the 2 groups. Results MMSE、MoCA and CDT scores of Nimodipine group(26.35±3.26, 25.53±4.31, 6.12±2.23, respectively), improved when compared with the control(23.12±3.45, 22.21±3.63, 4.35±2.61,respectively),and the difference was statistical significance (P<0.05). The patients with abnormal MoCA had lower scores in several cognitive domains (visuospatial and executive abilities, delayed memory, attention and capacity of calculation, abstract thinking (P<0.05) compared with control group. Conclusion Nimodipine could improve effectively the cognitive function in SCI patients and with a higher safety.