不同脑梗死急性期临床特点及疗效对比研究

目的分析不同面积脑梗死急性期的临床诊治特点和常见病因，为临床干预提供依据。方法选取2006年4月～2012年1月我科收治的不同面积脑梗死129例急性期患者，分为观察组（大面积脑梗死43例）和对照组（非大面积脑梗死86例），记录两组患者的临床诊治资料并进行对比性分析。结果观察组急性期出现意识障碍、完全偏瘫、失语、进行性颅内高压的比例高，梗死病灶分布范围广，并发肺炎、梗死后脑出血、应激性溃疡及病死率均明显高于对照组（P〈0．05）。经条件Logistic回归（按照1：2比例）分析常见病因，其中高龄、高血压、高血糖、高血脂、心脏病史、脑卒中史者发生大面积脑梗死的风险明显增加（P〈0．05）。结论大面积脑梗死患者急性期的症状重，预后差，及早干预发生大面积脑梗死的相关危险因素是降低其发生的有效措施。

Comparison of clinical diagnosis and treatment of massivecerebral infarction at acute stage.

Objective To analyze the results of diagnosis and treatment of cerebral infarction at acute stage and offer reference for clinical intervention. Methods Totally 129 cerebral infarction patients at acute stage were selected from April 2006 to January 2012 and divided into observation group （43 cases with large cerebral infarction area） and control group （86 cases with less cerebral infarction area）. The results of treatment of cases in both groups were compared. Results The proportions of conscious disturbance, complete hemiplegia, aphasia, progressively intracranial hypertension in patients of observation were high and the distribution of infarction foci was also wide in addition to complicated with pneumonia, cerebral hemorrhage after infarction, stress ulcer and mortality were also high in observation group compared to that of the control group （P 〈 0.05）. Logistic regression analysis showed that senile age, hypertension, hyperglycemia, hyperlipidemia, heart disease history, cerebral stroke were the risk factors associated with the occurrence of massive cerebral infarction （P 〈 0.05）. Conclusion The symptom of massive cerebral infarction is severe with unfavorable prognosis and early intervention is the effective measure to reduce the occurrence of massive cerebral infarction.