24例大面积脑梗死患者的临床分析(1)

http://www.100md.com 2015年8月15日 中国现代医生 2015年第23期

     [摘要] 目的 探讨大面积脑梗死的病因、临床特点、诊治及预后。 方法 回顾性分析2014年3月～2015年3月在武汉市第十四医院神经内科住院治疗56例脑梗死患者的临床资料，按照梗死面积分为病例组(大面积)和对照组(非大面积)，对两组患者的患病情况、诊断、治疗及预后进行分析和总结，并进行统计学分析。 结果 大面积脑梗死患者中既往高血压、房颤发生率较高。经统计学处理后，病例组患者Glasgow昏迷量表评分、生活能力Barthel指数低于对照组，神经功能缺损评分(NIHSS评分)高于对照组，差异有统计学意义(P<0.05)。病例组经内科保守治疗10～14 d，存活 21例，死亡4例。21例存活的患者中，偏瘫18例。 结论 大面积脑梗死患者起病急，临床症状重，治疗及预后欠佳。

    [关键词] 大面积脑梗死；神经功能缺损；生活能力

    [中图分类号] R743.3 [文献标识码] A [文章编号] 1673-9701(2015)23-0012-04

    Clinical analysis of 24 cases of patients with massive cerebral infarction

    DAI Qin

    Department of Neurology， the First People's Hospital in Jiangxia District in Wuhan City， Wuhan Fourteenth Hospital， Wuhan 430200， China

    [Abstract] Objective To explore the causes， clinical features， diagnosis， treatment and prognosis of massive cerebral infarction. Methods A retrospective analysis was conducted on the clinical data of 56 cases of patients with cerebral infarction from March 2014 to March 2015 in Department of Neurology， Wuhan Fourteenth Hospital， and the patients were divided into the case group (massive) and the control group (non-massive) according to infarction size. The sickness status， diagnosis， treatment and prognosis of patients in the two groups were summarized and analyzed statistically. Results There were higher incidences of atrial fibrillation and past hypertension in massive cerebral infarction patients. After statistical treatment， Glasgow Coma Scale and living ability Barthel index of patients in the case group were lower than those in the control group， and neurological deficits score(NIHSS score) of patients in case group was higher than that in the control group. The differences were statistically significant(P<0.05). After 10-14 days of medical conservative treatment， 21 cases of patients survived and 4 cases of patients died in the case group. Among the 21 cases of survivals， there were 18 patients with hemiplegia. Conclusion There are acute onset， severe clinical symptoms and poor treatment and prognosis in patients with massive cerebral infarction.

    [Key words] Massive cerebral infarction； Neurologic deficits； Living ability

    脑梗死是严重威胁人类身体健康的疾病，其病死率、致残率极高。而大面积脑梗死是脑梗死的一种特殊类型，其起病急，病情进展快，易出现严重脑水肿和颅内压增高症，部分患者会发生脑疝而死亡。因此，研究大面积脑梗死的病因、临床特点及诊治，可为预防、早期诊断、选择合适的治疗提供科学依据。本文回顾性分析我院神经内科56例脑梗死患者的临床资料，对其中24例大面积脑梗死的病因、病情特点、诊治、预后进行总结和探讨，现报道如下。

    1 资料与方法

    1.1 一般资料

    收集2014年3月～2015年3月在我院神经内科住院的 24 例大面积脑梗死患者为病例组，其中男 13例，女 11例，年龄50～90岁，平均(74.21±10.42)岁。以同期住院的32例非大面积脑梗死患者为对照组，其中男17例，女15例，年龄 51～88 岁，平均(69.09±8.72)岁。两组一般资料差异无统计学意义(P>0.05)，具有可比性。(戴琴)

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