泰舒达联合小脑顶核电刺激对急性脑梗死昏迷患者的疗效观察

发布时间：2018-06-15 10:44

本文选题：脑梗死 + 昏迷　；参考：《重庆医科大学》2013年硕士论文

【摘要】：目的观察泰舒达（trastal）联合小脑顶核电刺激（fastigial nucleusstimulation，FNS）治疗急性脑梗死昏迷患者的临床疗效。方法90例急性脑梗死昏迷患者随机分为3组，对照组1、对照组2、治疗组，每组30例。对照组1接受脑梗死伴昏迷的常规治疗，对照组2接受“常规治疗+小脑顶核电刺激”治疗，治疗组接受“常规治疗+泰舒达+小脑顶核电刺激”治疗。在治疗前、治疗后7d、14d、21d，分别采用格拉斯哥昏迷量表（Glasgow coma scale，GCS）和美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale，NIHSS)评定昏迷及神经功能缺损程度。3组疗程均为21天，治疗21d后进行临床疗效评定。结果治疗7d后，3组患者分别与各自基线水平比较，，临床症状改善但GCS及NIHSS评分无统计学差异（P0.05）。治疗l4d、21d后，3组患者GCS及NIHSS评分较基线水平均明显改善(P0.05)；治疗组GCS及NIHSS评分显著优于对照组1(P0.01)；与对照组2比较，治疗组GCS及NIHSS评分趋势好转（治疗14d、21d后，治疗组GCS评分均高于对照组2，NIHSS评分均低于对照组2），但统计学分析未见显著差异（P0.05）。3组患者在治疗21天后，进行临床疗效评定，浅昏迷、中度昏迷的患者促醒效果较好，而深昏迷患者基本无效。总体有效率：治疗组、对照组1、对照组2分别为93.3%、73.3%、86.7%。结论在急性脑梗死伴昏迷患者的常规治疗基础上，单纯加用小脑顶核电刺激治疗，其GCS及NIHSS评分可有好转趋势，但统计学差异不显著；而采用“泰舒达+小脑顶核电刺激”的联合治疗方案，则可显著改善轻、中度脑梗死昏迷患者的意识状态及神经功能缺损症状。
[Abstract]:Objective to observe the clinical effect of Tesustal combined with fastigial nucleus stimulation (FNSs) in the treatment of coma patients with acute cerebral infarction. Methods 90 patients with acute cerebral infarction coma were randomly divided into 3 groups: control group (1), control group (2), treatment group (30 cases). Control group 1 received routine treatment of cerebral infarction with coma, control group 2 received "routine treatment of cerebellar fastigial nuclear stimulation" and treatment group received "routine treatment of Tessuda cerebellar fastigial nuclear stimulation". Before and after treatment, Glasgow coma scale (Glasgow coma scale) and National Institutes of Health Stroke scale (NIHSS) were used to evaluate the severity of coma and neurological impairment for 21 days. The clinical efficacy was evaluated after 21 days of treatment. Results after 7 days of treatment, the clinical symptoms were improved, but there was no significant difference in the scores of GCS and NIHSS between the three groups compared with their baseline level (P 0.05). The scores of GCS and NIHSS in the treatment group were significantly better than those in the baseline level, the scores of GCS and NIHSS in the treatment group were significantly better than those in the control group (P 0.01), compared with the control group, the GCS and NIHSS scores in the treatment group were better than those in the control group (14 days and 21 days after treatment), and the scores of GCS and NIHSS in the treatment group were better than those in the control group (14 days and 21 days after treatment). The GCS score of the treatment group was higher than that of the control group (2NIHSS), but there was no significant difference between the two groups. But the deep coma patient basically has no effect. The total effective rate: treatment group, control group 1, control group 2 were 93.33.3and 86.7, respectively. Conclusion on the basis of routine treatment in patients with acute cerebral infarction and coma, the GCS and NIHSS scores of patients with acute cerebral infarction combined with coma can be improved, but there is no significant difference in GCS and NIHSS scores. The combined treatment of "Texuda cerebellar fastigial nuclear stimulation" can significantly improve the consciousness state and neurological deficit in patients with mild and moderate cerebral infarction.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

【参考文献】

中国期刊全文数据库前10条

1 李梅;冯华;;大面积脑梗死的临床表现及治疗方法[J];第三军医大学学报;2006年03期

2 江楠;郑烈辉;李作士;王鹏飞;;大骨瓣开颅减压术在大面积脑梗死治疗中的应用[J];广东医学;2011年11期

3 许梦雅;冯胜东;;小脑顶核电刺激加肢体电刺激在急性缺血性脑血管病的疗效观察[J];河南外科学杂志;2010年04期

4 李丽华;;胞二磷胆碱联合灯盏花素治疗脑梗死的临床效果分析[J];江西医药;2009年11期

5 姚雪鹏,董正坤,柴风良,孙兰香;胞二磷胆碱治疗脑血管病意识障碍80例临床观察[J];临床荟萃;1994年19期

6 詹克学;脑素联用胞二磷胆碱治疗脑梗死的临床研究[J];中原医刊;2005年20期

7 郑江环;;小脑顶核电刺激对昏迷患者应用观察[J];内蒙古中医药;2009年05期

8 关亚云;;醒脑静治疗重症脑梗塞伴昏迷病人的疗效观察[J];内蒙古中医药;2011年08期

9 李彩霞;;小脑顶核电刺激辅助治疗脑梗死48例临床疗效观察[J];山东医药;2006年05期

10 刘志高;王文国;;局部亚低温治疗急性脑梗死的临床观察[J];实用全科医学;2007年06期