不同治疗方案对大面积脑梗死神经功能评分的影响

目的探讨不同治疗方案对大面积脑梗死（Massivecerebralinfarction，MCI）患者神经功能评分的影响与治疗效果。方法回顾性分析41例MCI患者，其中15例采用阿替普酶溶栓治疗为研究组26例采用脱水降颅压、脑保护、稳定斑块等治疗为对照组，并分析年龄、性别、脑卒中危险因素（心房纤颤、高血压、糖尿病）、美国国立卫生研究院卒中量表（NIHSS）评分、格拉斯哥昏迷量表（GCS）评分、改良Rankin量表（mRS）评分、并发症等临床资料。结果研究组经溶栓治疗后24h（12．20±5．51和17．95±5．58，t=3．13，P=0．004）及7d（10．00±5．26和15．00±6．32，f=-2．48，P=0．02）NIHSS评分均低于对照组，差异有统计学意义。结论严格掌握好溶栓适应症可以改善大面积脑梗死临床神经功能评分。

The Influence of Intravenous Thrombolysis and Other Therapies in Patients with Massive Cerebral Infarction

Objective To explore the influence of intravenous thrombolysis and other therapies in patients with massive cerebral infarction（MCI）. Methods Clinical data of 15 patients with acute MCI receiving thrombolytic therapy with alteplase and 26 MCI patients without receiving thrombolytic therapy were retrospectively analyzed. The U.S. National Institutes of Health Stroke Scale（NHISS）and modified Rankin Scale（mRS）were used to identify the extent of neurological function improvement and prognosis of patients at 24 b and 7 days after treatment. Results The significant differences in NIHSS at 24th hour （12.20±5.51vs17.95±5.58, t=-3.13, P=-0.004） and 7th day（10.00±5.26 vs15.00±6.32, t=-2.48, P=-0.02）were both found between intravenous thrombolysis and control group. Conclusion Strictly grasping the thrombolytic indications of patient with massive cerebral infarction could improve their clinical neurological functions.