滨州医学院学报
濱州醫學院學報
빈주의학원학보
JOURNAL OF BINZHOU MEDICAL COLLEGE
2015年
2期
97-100
,共4页
于天霞%马丽丽%杜文贞%邵鹏%任金岩%郑娟%闫志慧%王敏%于凌%孔敏%梁辉
于天霞%馬麗麗%杜文貞%邵鵬%任金巖%鄭娟%閆誌慧%王敏%于凌%孔敏%樑輝
우천하%마려려%두문정%소붕%임금암%정연%염지혜%왕민%우릉%공민%량휘
全身亚低温%脑梗死%时间窗%预后
全身亞低溫%腦梗死%時間窗%預後
전신아저온%뇌경사%시간창%예후
mild hypothermia%cerebral infarction%the time window%prognosis
目的:研究全身亚低温不同起始时间对急性脑梗死近期与远期预后的影响,以进一步探讨亚低温治疗最佳时间窗。方法对急性大面积脑梗死患者117例,随机分为亚低温治疗组6~12 h 时(A1)22例及12~24 h(A2)32例;对照组6~12 h (B1)30例及12~24 h(B2)33例。对照组予常规抗血小板、降脂稳定斑块、改善循环、脑保护及对症治疗,亚低温治疗组在常规治疗的基础上采用全身亚低温治疗,配合冬眠合剂。使肛温控制在33~35℃。降温持续时间5~7 d 。评定治疗前、治疗后第7、14天、1、3、6个月各时间点 NIHSS 评分、MRS 评分。并记录死亡、再发脑梗死等终点事件。结果①起始时间6~12 h与12~24 h 亚低温治疗组的近期疗效与远期疗效均优于各自对照组。②6~12 h 亚低温组近期与远期疗效均优于12~24 h亚低温组。③肺部感染是亚低温治疗较常见并发症,但可降低急性脑梗死患者应激性溃疡、脑心综合征的并发症。结论24 h 内长程亚低温治疗急性脑梗死可改善神经功能,降低致残率,且越早效果越好。
目的:研究全身亞低溫不同起始時間對急性腦梗死近期與遠期預後的影響,以進一步探討亞低溫治療最佳時間窗。方法對急性大麵積腦梗死患者117例,隨機分為亞低溫治療組6~12 h 時(A1)22例及12~24 h(A2)32例;對照組6~12 h (B1)30例及12~24 h(B2)33例。對照組予常規抗血小闆、降脂穩定斑塊、改善循環、腦保護及對癥治療,亞低溫治療組在常規治療的基礎上採用全身亞低溫治療,配閤鼕眠閤劑。使肛溫控製在33~35℃。降溫持續時間5~7 d 。評定治療前、治療後第7、14天、1、3、6箇月各時間點 NIHSS 評分、MRS 評分。併記錄死亡、再髮腦梗死等終點事件。結果①起始時間6~12 h與12~24 h 亞低溫治療組的近期療效與遠期療效均優于各自對照組。②6~12 h 亞低溫組近期與遠期療效均優于12~24 h亞低溫組。③肺部感染是亞低溫治療較常見併髮癥,但可降低急性腦梗死患者應激性潰瘍、腦心綜閤徵的併髮癥。結論24 h 內長程亞低溫治療急性腦梗死可改善神經功能,降低緻殘率,且越早效果越好。
목적:연구전신아저온불동기시시간대급성뇌경사근기여원기예후적영향,이진일보탐토아저온치료최가시간창。방법대급성대면적뇌경사환자117례,수궤분위아저온치료조6~12 h 시(A1)22례급12~24 h(A2)32례;대조조6~12 h (B1)30례급12~24 h(B2)33례。대조조여상규항혈소판、강지은정반괴、개선순배、뇌보호급대증치료,아저온치료조재상규치료적기출상채용전신아저온치료,배합동면합제。사항온공제재33~35℃。강온지속시간5~7 d 。평정치료전、치료후제7、14천、1、3、6개월각시간점 NIHSS 평분、MRS 평분。병기록사망、재발뇌경사등종점사건。결과①기시시간6~12 h여12~24 h 아저온치료조적근기료효여원기료효균우우각자대조조。②6~12 h 아저온조근기여원기료효균우우12~24 h아저온조。③폐부감염시아저온치료교상견병발증,단가강저급성뇌경사환자응격성궤양、뇌심종합정적병발증。결론24 h 내장정아저온치료급성뇌경사가개선신경공능,강저치잔솔,차월조효과월호。
Objective To observe the short‐dated and long‐dated effect of mild hypothermia therapy in different begining time on patients with acute cerebral infaction .Methods 117 patients with acute large area cerebral infarction patients ,according to starting time randomly divided into the mild hypothermia treatment group as 6 ~ 12 hours group (A1) 22 cases ;12 ~ 24 hours group(A2) 32 cases ;in control group as 6 ~ 12 hours group(B1) 30 cases and 33 cases of 12 ~ 24 hours group(B2) .Control group with antiplatelet ,stable plaques ,improve circulation ,brain protection treatment .Mild hypothermia treatment group was implementing 33 ~ 35 ℃ mild hypothermia therapy with hibernate medicines besides the basis of treatment .Duration of 5 ~ 7 days .Evaluation before the treatment and after the treatment of 7 days ,14 days ,1 month ,3 months ,half year with NIHSS score and MRS score .Results ① group A1 is superior to control group B1 .group A2 is superior to control group B2 ② group A1 is superior to group A2 ③ the lung infection is common complication ,but there was no statistically significant difference compared with control group .Conclusion 24 hours long‐term mild hypothermia therapy on acute cerebral infarction can improve nerve function ,reduce the mortality rate ,and the sooner the better .