外科手术联合自体骨髓干细胞动员治疗急性大面积脑梗死疗效观察

目的：探讨外科手术联合自体骨髓干细胞动员治疗急性大面积脑梗死的疗效及安全性。方法：将61例急性大面积脑梗死患者随机分为外科手术对照组和外科手术联合自体骨髓干细胞动员治疗组。比较患者治疗前后Barthel in-dex（BI）和中国卒中评分（Chinese stroke scale,CSS）。结果：对照组死亡2例,治疗组失访1例;治疗后1个月两组BI和CSS评分无统计学意义（P〉0.05）;治疗后3个月,治疗组BI评分明显高于对照组（P〈0.05）,CSS评分较对照组显著下降（P〈0.05）,治疗组未出现严重不良反应。结论：外科手术联合自体骨髓干细胞动员治疗急性大面积脑梗死安全有效,可显著改善患者神经功能和预后。

Study on Treatment of Acute Massive Cerebral Infarction by Surgical Operation Combined with Autologous Bone Marrow Stem Cell Mobilization

Objective：To explore the effect and mechanism of the trea＇tment of acute massive cerebral infarction by surgical operation combined with autologous bone marrow stem cell mobilization. Methods：61 cases of acute massive cerebral infarction were randomly divided into surgical operation control group,surgical operation combined with autologous bone marrow stem cell mobilization treatment group,30 cases of control group ,acceptance of large craniotomy and roofing of temporal muscles;31 cases of treatment group,with conventional surgical treatment ,and then administrating the recombinant human granulocyte colony stimulating actor （rhG-CSF）,recombinant human granulocyte macrophage colony stimulating factor （rhGM-CSF） ;two groups of cases were assessed by Barthel Index （BI） and the Chinese stroke scale （CSS） table in the pre treatment,treatment after a month and 3 months respectively,observed the adverse reactions of rhG~CSF, rhGM-CSF during the period of treatment. Results ：Surgical operation control group 30 cases,had two cases death,no lose vmiting ;surgical operation combined with autologous bone marrow stern cell mobilization treatment group 31 cases ,had no death cases,one case lose visiting,two groups had improved after treatment two months,but was no significant difference （P〉0. 05）;3 months after treatment,BI score increased in both groups,surgical operation com- bined with autologous bone marrow stem ceil mobilization treatment group BI score was higher than surgical operation control group,and had statistically significant difference between the two groups （P〈0. 05） ;The two groups CSS score had declined after treatment a month,but the two groups was not significant （P〉0.05）,3 months after treatment,sur- gical operation combined with autologous bone marrow stem cell mobilization treatment group CSS score dropped signifi- cantly, there was a statistical significance between the two groups （P〈0. 05）. No major adverse events were observed in the surgical operation combined with autologous bone marrow stem cell mobilization treatment group. Conclusion： The treatment to acute massive cerebral infarction by surgical operation combined with autologous bone marrow stem cell mobilization is safe and effective ,significantly improve neurological function and prognosis of patients.