注射用丹参多酚酸治疗合并肺部感染的急性轻中度脑梗塞临床疗效观察

发布时间：2018-04-15 07:20

本文选题：缺血性脑卒中 + 肺部感染　；参考：《吉林大学》2017年硕士论文

【摘要】：缺血性脑卒中往往合并系统性并发症,延长了住院时间,增加经济负担,使死亡率进一步升高。寻找行之有效的措施预防和治疗合并肺部感染的脑梗塞具有重要临床意义。研究目的:观察丹参多酚酸治疗合并肺部感染的急性轻中度脑梗塞患者治疗前,治疗2周后,3个月后神经功能缺损评分(NIHSS评分)及三个月后日常生活能力(ADL评分)变化,探讨应用丹参多酚酸治疗脑梗塞合并肺部感染的临床疗效。研究方法:将合并肺部感染的急性轻中度脑梗塞患者110例随机分为2组,肺部感染用药组给予注射用丹参多酚酸,肺部感染非用药组作为常规治疗组。另选55例不合并肺部感染的急性轻中度脑梗塞患者作为脑梗塞用药组,同样给予丹参多酚酸治疗。分别评价各组患者治疗前、治疗后2周,治疗后3个月神经功能缺损评分(NIHSS评分)及治疗3个月的日常生活能力(Activities of Daily Living ADL)。每组均给予相同的基础治疗:舒血宁注射液,肌氨肽苷注射液,以及支持治疗包括高血压、糖尿病、高血脂等治疗。肺部感染用药组及常规治疗组均给予敏感抗生素治疗肺部感染。研究结果:1.肺炎用药组、常规治疗组和脑梗塞用药组2周时间点NIHSS评分较入院时均降低,具有统计学差异(P0.05);肺炎用药组与常规治疗组2周时间点NIHSS评分比较,肺炎用药组下降更明显,差异具有统计学意义(P0.05);肺炎用药组和脑梗塞用药组2周时间点NIHSS评分比较,脑梗塞用药组下降更明显,二者比较差异具有统计学意义(P0.05)。肺炎用药组与常规治疗组3个月NIHSS评分比较,肺炎用药组NIHSS评分下降明显,二者之间的差异具有统计学意义(P0.05);肺炎用药组与脑梗塞用药组于3个月时间点NIHSS评分均下降,二者之间差异无统计学意义(P0.05)。2.肺炎用药组与常规治疗组3个月ADL评分比较,肺炎用药组3个月时间点ADL评分高于常规治疗组,具有统计学差异(P0.05);肺炎用药组与脑梗塞用药组3个月ADL评分比较,肺炎用药组ADL评分稍高于脑梗塞用药组,但二者之间的差异无统计学意义(P0.05)。3.三组患者2周时监测血常规、尿常规、凝血常规、心肌酶等,其结果与入院时相比未见明显异常,于用药期间并无异常症状出现。结论:1.急性期加用丹参多酚酸能够改善患者3个月神经功能及日常生活能力。2.肺部感染延迟急性轻中度脑梗塞2周时间点神经功能恢复,但不影响3个月后神经功能恢复及日常生活能力。3.注射用丹参多酚酸能够改善合并肺部感染的急性轻中度缺血性脑卒中的神经功能和日常生活能力,对合并肺部感染的脑梗塞有效。
[Abstract]:Ischemic stroke often complicates systemic complications, prolongs hospital stay, increases economic burden and further increases mortality.It is of great clinical significance to find effective measures to prevent and treat cerebral infarction complicated with pulmonary infection.Objective: to observe the effects of salvia miltiorrhiza polyphenolic acid on acute mild to moderate cerebral infarction patients with pulmonary infection before, 2 weeks and 3 months after treatment.To investigate the clinical effect of salvia miltiorrhiza polyphenolic acid in the treatment of cerebral infarction complicated with pulmonary infection.Methods: 110 patients with acute mild and moderate cerebral infarction complicated with pulmonary infection were randomly divided into two groups: the drug group of pulmonary infection was given salvia miltiorrhiza polyphenolic acid for injection and the group of non-medication for pulmonary infection was used as routine treatment group.Another 55 patients with acute mild to moderate cerebral infarction without pulmonary infection were treated with salvia miltiorrhiza and polyphenolic acid.Before treatment, 2 weeks after treatment and 3 months after treatment, the neurological deficit score (NIHSS) and activities of Daily Living (ADL) were evaluated in each group.Each group was given the same basic treatment: Shuxuening injection, carnosine injection, and supportive therapy including hypertension, diabetes, hyperlipidemia and so on.Lung infection group and routine treatment group were given sensitive antibiotics to treat pulmonary infection.The result of the study was: 1.The scores of NIHSS at 2 weeks in the treatment group, routine treatment group and cerebral infarction group were significantly lower than those in the admission group (P 0.05), and the NIHSS scores at the 2 week point in the pneumonia medication group were significantly lower than those in the routine treatment group.The difference was statistically significant (P 0.05), and the NIHSS score at 2 weeks in the pneumonia group and the cerebral infarction group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P 0.05).Compared with the routine treatment group, the NIHSS score of the pneumonia medication group decreased significantly, the difference between the two groups was statistically significant (P 0.05), the NIHSS score of the pneumonia medication group and the cerebral infarction group decreased at 3 months.There was no significant difference between the two groups (P 0.05. 2).Compared with the routine treatment group, the 3-month ADL score of the pneumonia medication group was higher than that of the routine treatment group at 3 months, and the ADL score of the pneumonia medication group and the cerebral infarction group was higher than that of the routine treatment group (P 0.05).The ADL score of pneumonia group was slightly higher than that of cerebral infarction group, but there was no significant difference between the two groups (P 0.05. 3).The blood routine, urine routine, coagulation routine and myocardial enzyme were monitored in the three groups at 2 weeks. The results were not significantly abnormal compared with those on admission, and no abnormal symptoms appeared during the treatment period.Conclusion 1.Salvia miltiorrhiza polyphenolic acid in acute phase can improve the neurological function and ADL of the patients for 3 months.Pulmonary infection delayed the recovery of nerve function at 2 weeks after acute mild to moderate cerebral infarction, but did not affect the recovery of nerve function and activity of daily living after 3 months.Salvia miltiorrhiza polyphenolic acid for injection can improve the neurological function and daily living ability of acute mild to moderate ischemic stroke complicated with pulmonary infection and is effective for cerebral infarction complicated with pulmonary infection.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.33;R563.1

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