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目的:评估米力农注射液在治疗顽固性脑血管痉挛伴有临床症状患者中的安全性和有效性。方法:研究对象为8例蛛网膜下腔动脉瘤破裂出血后通过常规药物治疗不能缓解的有顽固性脑血管痉挛症状的患者,以0.25 mg.min-1的速度(总剂量10～15 mg)在动脉内输注米力农注射液,对患者血管造影术结果、神经和心血管系统性并发症以及脑功能恢复结果进行了评估,观察药物的疗效。结果:所有患者的血管造影结果都有明显改善。用药前患者颅内血管痉挛狭窄大于70%,当动脉内输入米力农注射液后狭窄程度小于50%,有3名患者出现复发的血管痉挛,经第二次治疗后好转,治疗中没有1例患者发生神经或心血管并发症。在治疗后的3个月的后续随访中,所有的患者都存活了下来,兰金评分为2±1,巴氏指数为83±10。结论:对于由蛛网膜下腔动脉瘤破裂出血引发的顽固性脑血管痉挛症状的患者来说,动脉内输入米力农注射液是一种安全有效的治疗方法。
OBJECTIVE: To assess the safety and efficacy of milrinone in patients with refractory cerebral vasospasm associated with clinical symptoms. Methods: The study was performed in 8 patients with subarachnoid aneurysm rupture hemorrhage who had refractory symptoms of cerebral vasospasm that could not be relieved by conventional medical treatment. The patients were treated with 0.25 mg.min-1 (total dose 10-15 mg) Milrinone was infused intraarterially to assess angiographic outcomes, neurological and cardiovascular complications, and recovery of brain function. The efficacy of the drug was observed. Results: Angiographic findings were significantly improved in all patients. Before treatment, patients with intracranial vasospasm stenosis greater than 70%, when the intra-arterial infusion of milrinone stenosis less than 50%, 3 patients with recurrent vasospasm, after the second improvement, there is no treatment 1 Cases of patients with neurological or cardiovascular complications. At follow-up of 3 months after treatment, all patients survived with a Rankin score of 2 ± 1 and a Papanicum index of 83 ± 10. CONCLUSIONS: Intra-arterial infusion of milrinone is a safe and effective treatment for patients with refractory cerebral vasospasm caused by ruptured hemorrhage in the subarachnoid aneurysm.