短暂性肢体缺血后处理治疗急性脑梗死的疗效观察

发布时间：2018-06-25 04:26

本文选题：脑梗死 + 远端肢体缺血后处理　；参考：《中风与神经疾病杂志》2017年05期

【摘要】：目的探讨肢体缺血后处理治疗急性脑梗死的临床疗效。方法选择2015年3月~2016年6月在我院住院治疗的158例未进行溶栓治疗的急性脑梗死(发病72 h内)患者作为研究对象,所有患者均经影像证实,按照入院先后顺序随机分为治疗组和对照组。所有患者均给予常规治疗,治疗组在常规治疗的基础上给予4个短周期单侧上肢缺血再灌注,每天进行1次连续7 d。比较入院时和病程14 d时两组患者的临床疗效;入院时、病程14 d和病程3 m时的美国国立卫生研究院卒中量表(NIHSS)和磁共振灌注加权成像(PWI);入院时和病程3 m时的改良Rankin量表(mRS)、梗死体积。结果治疗14 d后,治疗组总有效率(95.9%)高于对照组(79.0%),差异有统计学意义(P0.05);两组患者NIHSS评分、rMTT在入院时和病程14 d时差异无统计学意义,均在病程3 m时差异有统计学意义(P0.05);病程3 m时,治疗组mRS较对照组下降(P0.05),治疗组梗死体积较对照组减小(P0.05)。结论在急性脑梗死患者常规治疗的基础上给予短暂性肢体缺血后处理治疗,可以提高患者的临床疗效,减轻NIHSS评分及mRS评分,减小梗死体积,增加脑灌注。
[Abstract]:Objective to investigate the clinical effect of limb ischemic post-treatment on acute cerebral infarction. Methods 158 patients with acute cerebral infarction (within 72 hours of onset) who were hospitalized in our hospital from March 2015 to June 2016 were selected as study subjects. According to the order of admission, they were randomly divided into treatment group and control group. All the patients were given routine therapy. The treatment group was treated with 4 short cycles of unilateral upper limb ischemia / reperfusion on the basis of routine treatment, once a day for 7 days. The clinical effects of the two groups were compared at admission and 14 days after admission. The stroke scale (NIHSS) and magnetic resonance perfusion weighted imaging (PWI) of the National Institutes of Health (NIH), modified Rankin scale (Mrs) and infarct volume at admission and 3 m after the course of the disease. Results after 14 days of treatment, the total effective rate in the treatment group (95.9%) was higher than that in the control group (79.0%), the difference was statistically significant (P0.05). At 3 m course of disease, the difference was statistically significant (P0.05); at 3 m course of disease, Mrs in the treatment group was lower than that in the control group (P0.05), and the infarct volume in the treatment group was smaller than that in the control group (P0.05). Conclusion on the basis of routine treatment in patients with acute cerebral infarction, temporary post-treatment of limb ischemia can improve the clinical efficacy, reduce NIHSS score and Mrs score, reduce infarct volume and increase cerebral perfusion.
【作者单位】：河南省人民医院神经内科;黄河中心医院神经内科;河南省人民医院医学影像中心;
【基金】：河南省科学技术厅项目(No.152102410083)
【分类号】：R743.33

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