| 肖晗,李雪明,周云.大脑中动脉大面积脑梗死患者的临床特点、头颅影像学特征及早期康复效果分析[J].中国临床保健杂志,2023,26(6):839-843. |
| 大脑中动脉大面积脑梗死患者的临床特点、头颅影像学特征及早期康复效果分析 |
| Clinical characteristics,head imaging,and early rehabilitation efficacy of patients with large area middle cerebral artery infarction |
| 投稿时间：2023-10-15 |
| DOI：10.3969/J.issn.1672-6790.2023.06.028 |
| 中文关键词: 脑梗死 大脑中动脉 康复 治疗结果 |
| 英文关键词: Brain infarction Middle cerebral artery Rehabilitation Treatment outcome 〖FL |
| 基金项目:安徽省重点研究和开发计划项目(201904a07020067) |
|
| 摘要点击次数: 499 |
| 全文下载次数: 316 |
| 中文摘要: |
| 目的 探讨大脑中动脉大面积脑梗死患者的临床、头颅影像学特征及早期康复效果。方法 回顾性分析2019年5月至2021年5月安徽医科大学第二附属医院临床资料完整、影像学资料齐全的75例大脑中动脉大面积脑梗死患者病历资料,其中男42例,女33例,年龄28~94岁。按有无康复治疗分为康复治疗组(14例)和无康复治疗组(61例),比较2组患者入出院格拉斯哥昏迷量表评分(GCS)、美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Berg评分、Bathel指数量表(BI)评分、Morse评分、疼痛视觉模拟评分(VAS)和出院转归。并对大脑中动脉大面积脑梗死进行多因素logistic回归分析。结果 大脑中动脉大面积脑梗死意识障碍多见,常同时累及上下肢,完全性瘫痪比例高。头颅CT显示脑梗死区域较广泛,易累及大脑皮质支配区。康复治疗组入院/出院GCS、NIHSS、mRS、BI和Berg评分对比,差异有统计学意义(P<0.05),Morse、VAS评分差异无统计学意义；无康复治疗组出院较入院,VAS评分显著降低、BI评分显著增高,差异有统计学意义(P<0.05),而GCS、NIHSS、mRS、Berg、Morse评分,差异无统计学意义(P>0.05)。康复治疗组较无康复治疗组在出院转归方面,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,入院时头颅CT-ASPECTS及GCS评分与去骨瓣减压术、梗死后出血性转化、恶性脑水肿呈负相关(P<0.05)。结论 大脑中动脉大面积脑梗死早期康复治疗可显著改善大面积脑梗死患者的意识状态、神经功能、日常生活活动能力及平衡能力,减轻残疾程度,改善出院转归。 |
| 英文摘要: |
| Objective To explore the clinical and cranial imaging patterns of patients with large hemispheric infarction and the significance of rehabilitation treatment.Methods A total of 75 patients diagnosed with extensive cerebral infarction were selected from Second Affiliated Hospital of Anhui Medical University records spanning from May 2019 to May 2021.These patients were chosen based on the availability of complete clinical and imaging data.Among the selected patients,there were 42 males and 33 females,ranging in age from 28 to 94 years.Furthermore,the patients were divided into two groups:the rehabilitation treatment group (n=14) and the non-rehabilitation treatment group (n=61),Compare the GCS,NIHSS,mRS,Berg,BI,Morse,VAS scores,and discharge outcomes of two groups of patients at discharge compared to admission.Results The consciousness disorders were prevalent among patients afflicted with substantial cerebral infarction,often affecting both upper and lower limb muscular strength,with a heightened likelihood of complete paralysis.Furthermore,the cerebral infarction region observed in head CT scans tends to be more extensive and prone to involvement of the cerebral cortical innervation area.The difference in GCS,NIHSS,mRS,BI and Berg scores between the rehabilitation treatment group and the non rehabilitation treatment group was statistically significant (P<0.05) Admission/Discharge,while the difference in Morse and VAS scores was not statistically significant.In the non rehabilitation treatment group,admission/discharge showed a significant decrease in VAS score and a significant increase in BI score,and the difference was statistically significant (P<0.05),but there was no statistically significant difference in GCS,NIHSS,mRS,Berg,and Morse.There was a significant difference in discharge outcomes between the rehabilitation treatment group and the non rehabilitation treatment group (P<0.05).Multivariate logistic regression analysis showed that the head CT-ASPECTS score and admission GCS were negatively correlated with decompressive craniectomy,post infarction hemorrhagic transformation,and malignant brain edema (P<0.05).Conclusions Early rehabilitation treatment for large area cerebral infarction in the middle cerebral artery can significantly improve the consciousness state,neurological function,daily living activity and balance ability of patients with large area cerebral infarction,reduce disability,and improve discharge outcomes. |
|
查看全文
|
| 关闭 |
|
|
|