摘要
目的观察亚低温联合依达拉奉治疗对急性脑梗死患者近期预后的影响。方法将发病时间≤72h的245例急性脑梗死患者按就诊时间先后顺序分为联合治疗组（65例）、亚低温组（59例）、依达拉奉组（58例）和对照组（63例）；所有患者均给予常规药物治疗，亚低温组加亚低温治疗，依达拉奉组加依达拉奉治疗，联合治疗组同时加亚低温和依达拉奉治疗。在治疗前及治疗后30d时对患者进行欧洲卒中量表（ESS）评分，在治疗前及治疗后30、90d时对患者进行日常生活能力（ADL）评分。结果联合治疗组、亚低温组、依达拉奉组、对照组治疗前ESS评分分别为（45．22±16．94）、（46．884±22．54）、（47．13±10．92）、（46．944±16．41）分，ADL评分分别为（20．544±14．65）、（20．944±10．93）、（21．834±14．71）、（23．614±18．91）分，各组间比较差异无统计学意义（P〉0．05）。联合治疗组ADL评分在治疗后30d为（59．574±30．99）分、90d为（74．464±25．61）分，比亚低温组的（43．914±27．61）、（58．13±26．62）分和对照组的（34．584±27．75）、（45．56±26．10）分高，差异有统计学意义（尸〈0．05），在治疗后90d比依达拉奉组的（62．834±28．74）分高，差异有统计学意义（P〈0．05）。联合治疗组ESS评分在治疗后30d为（72．244±14．54）分，与亚低温组的（65．884±17．76）分、依达拉奉组的（65．27±18．02）分、对照组的（60．62±14．97）分比较差异有统计学意义（P〈0．05）。联合治疗组临床显效率为63．08％（41／65），明显高于亚低温组的42．37％（25／59）、依达拉奉组的41．38％（24／58）和对照组的23．81％（15／63），差异有统计学意义（P〈0．05）。而联合治疗组的病死率为9．23％（6／65），低于亚低温组的10．17％（6／59）、依达拉奉组的12．07％（7／58）、对照组的12．70％（8／63），但差异无统计学意义（P〉0．05）。结论亚低温联合依达拉奉治疗明显提高急性脑梗死患者的近期预后。
Objective To explore the prognostic influence of combination therapy with mild hypothermia and edaravone for acute cerebral infarction. Methods Two hundred and forty-five cases of diagnosed as acute cerebral infarction within 72 hours of onset were randomly divided into four groups according to the doctor visiting time. All the groups were treated with routine drugs. Combined therapy group （65 cases ） was treated with mild hypothermia combined with edaravone. Mild hypothermia group （59 cases） was treated with local mild hypothermia. Edaravone group （58 cases） was treated with edaravone. Control group （63 cases） was only treated with routine drugs. The European Stroke Scale （ESS） score was performed before treatment, 30 days after treatment. The activity of daily living （ADL） scores were evaluated before treatment, 30 and 90 days after treatment. Results ESS scores were （45.22 ± 16.94）, （46.88 ± 22.54）,（47.13 ± 10.92）, （46.94 ± 16.41） scores before treatment in combined therapy group,mild hypothermia group, edaravone group, control group respectively. ALD scores were （20.54 ± 14.65）, （20.94 ± 10.93 ）, （21.83 ± 14.71 ）, （23.61 ± 18.91 ）seores before treatment in eombined therapy group,mild hypothermia group, edaravone group, control group respectively. There were no differences in ESS and ADL seores before treatment among the groups. ADL scores were higher 30, 90 days after treatment in combined therapy group [（59.57 ± 30.99）, （74.46 ±25.61） scores] than those in mild hypothermia group [（43.91 ±27.61）, （58.13 ±26.62） seores） and control group [（34.58 ±27.75）, （45.56 ±26.10） scores]（P 〈0.05） and higher after 90 days treatment than that in edaravone group [ （ 62.83 ± 28.74 ） scores ] （P 〈 0.05 ）. ESS scores 30 days after treatment in combined therapy group [ （72.24 ± 14.54） scores ] were higher than those in mild hypothermia group [（65.88 ± 17.76） scores], edaravone group [（65.27 ± 18.02） scores], control group [（60.62 ± 14.97） scores] （P 〈 0.05 ）. The effectiveness in combined therapy group [ 63.08% （41/65）] was higher than that in mild hypothermia group [42.37%（25/59）], edaravone group [41.38% （24/58）3 and control group [ 23.81% （15/63）1 （P 〈 0.05 ）. The mortality rate in combined therapy group [ 9.23% （6/65）] was lower than that in mild hypothermia group[ 10.17%（6/59 ） ], edaravone group[ 12.07%（7/58 ） ] and eontrol group [ 12.70% （8/63） ], but there was no significant difference （P 〉 0.05 ）. Conclusion The combination therapy with mild hypothermia and edaravone can improve the prognosis of acute cerebral infarction.
出处
《中国医师进修杂志》
2012年第27期8-11,共4页
Chinese Journal of Postgraduates of Medicine
基金
江苏省南通市社会发展科技计划（通科计[2008]加6号）
关键词
脑梗塞
亚低温
依达拉奉
Brain infarction
Mild hypothermia
Edaravone
