亚低温对急性缺血性脑血管疾病患者脑保护的作用研究(1)
【摘要】 目的：探讨亚低温对急性缺血性脑血管疾病患者脑保护的作用。方法：选取2017年11月-2018年4月本院收治的急性脑梗死患者180例，按治疗方法不同分为对照组、单纯动脉溶栓组与区域性血管内低温加动脉溶栓组，各60例。对照组应用常规治疗方法，单纯动脉溶栓组应用单纯的动脉溶栓治疗方法，区域性血管内低温加动脉溶栓组在亚低温环境下进行动脉溶栓治疗的方法。比较三组治疗情况、美国国立卫生研究院卒中量表(NIH stroke scale，NIHSS)评分及并发症发生率。结果：区域性血管内低温加动脉溶栓组治疗效果优于对照组和单纯动脉溶栓组(P<0.05);区域性血管内低温加动脉溶栓组治疗后24 h、2周NIHSS评分及并发症发生率均低于对照组和单纯动脉溶栓组(P<0.05)。结论：急性缺血性脑血管疾病在亚低温环境下进行动脉溶栓治疗对脑保护效果理想，临床上应推广应用。
【关键词】 亚低温 急性缺血性脑血管疾病 动脉溶栓
Effect of Mild Hypothermia on Brain Protection in Patients with Acute Ischemic Cerebrovascular Disease/XI Fuqiang， XUE Jijiao. //Medical Innovation of China， 2019， 16(29)： 0-072
[Abstract] Objective： To investigate the effect of mild hypothermia on brain protection in patients with acute ischemic cerebrovascular disease. Method： A total of 180 patients with acute cerebral infarction admitted to our hospital from November 2017 to April 2018 were selected. According to different treatment methods， they were divided into the control group， the simple arterial thrombolysis group and the regional intravascular hypothermia plus arterial thrombolysis group， 60 cases in each group. The control group received conventional treatment， the simple arterial thrombolysis group was treated with simple arterial thrombolysis， and the regional intravascular hypothermia plus arterial thrombolysis group was used for arterial thrombolysis in a mild hypothermia environment. The three groups of treatments， the National institutes of health stroke scale (NIHSS) score， and the incidence of complications were compared. Result： The treatment effect of regional intravascular hypothermia plus arterial thrombolysis group was better than those of the control group and the simple thrombolysis group (P<0.05). The NIHSS score at after treatment 24 h， 2 weeks and complication rate of the regional intravascular hypothermia plus arterial thrombolysis group were lower than those of the control group and the simple thrombolysis group (P<0.05). Conclusion： Arterial thrombolysis in mild hypothermia for acute ischemic cerebrovascular disease has an ideal effect on brain protection. And it should be popularized in clinic.
[Key words] Mild hypothermia Acute ischemic cerebrovascular disease Artery thrombolysis
First-author’s address： Inner Mongolia University of Science and Technology Baotou Medical College First Affiliated Hospital， Baotou 014010， China
doi：10.3969/j.issn.1674-4985.2019.29.018
腦梗死是一种现实中非常常见的脑血管疾病，有较高的致残率与病死率，会严重影响了人的生命健康。人类将低温治疗技术应用在疾病治疗中的历史最早可以追溯到两千多年前的古埃及，那时人类就已经采用低温冷敷的方式进行止痛，并取得了比较好的效果[1-2]。一开始，低温在医学上的应用主要侧重于对冻伤的救治，至于低温治疗在脑部疾病上的应用，开始的比较晚，20世纪50年代左右，有国外的学者才在护脑复苏与脑保的领域采用低温治疗的研究，随之发现对大鼠的体温进行轻度降低也能减少因为缺血导致的神经细胞的死亡，而且其效果和深低温所产生的效果相同，更重要的是，这种温度下不会发生深低温作用下的并发症[3-5]。当前，在脑保护的研究医疗实践中，一般是采用28～35 ℃亚低温，特别是在一些医疗条件比较好的医院中，亚低温治疗方法已经被作为脑血管疾病以及重型颅脑损伤的常规辅助的治疗方法[6-8]。本文主要是对急性脑梗死动脉溶栓联合血管内低温灌注的研究，探讨亚低温对脑缺血性损害神经保护作用的可能机制。现报道如下。, http://www.100md.com(席富强 薛继娇)
【关键词】 亚低温 急性缺血性脑血管疾病 动脉溶栓
Effect of Mild Hypothermia on Brain Protection in Patients with Acute Ischemic Cerebrovascular Disease/XI Fuqiang， XUE Jijiao. //Medical Innovation of China， 2019， 16(29)： 0-072
[Abstract] Objective： To investigate the effect of mild hypothermia on brain protection in patients with acute ischemic cerebrovascular disease. Method： A total of 180 patients with acute cerebral infarction admitted to our hospital from November 2017 to April 2018 were selected. According to different treatment methods， they were divided into the control group， the simple arterial thrombolysis group and the regional intravascular hypothermia plus arterial thrombolysis group， 60 cases in each group. The control group received conventional treatment， the simple arterial thrombolysis group was treated with simple arterial thrombolysis， and the regional intravascular hypothermia plus arterial thrombolysis group was used for arterial thrombolysis in a mild hypothermia environment. The three groups of treatments， the National institutes of health stroke scale (NIHSS) score， and the incidence of complications were compared. Result： The treatment effect of regional intravascular hypothermia plus arterial thrombolysis group was better than those of the control group and the simple thrombolysis group (P<0.05). The NIHSS score at after treatment 24 h， 2 weeks and complication rate of the regional intravascular hypothermia plus arterial thrombolysis group were lower than those of the control group and the simple thrombolysis group (P<0.05). Conclusion： Arterial thrombolysis in mild hypothermia for acute ischemic cerebrovascular disease has an ideal effect on brain protection. And it should be popularized in clinic.
[Key words] Mild hypothermia Acute ischemic cerebrovascular disease Artery thrombolysis
First-author’s address： Inner Mongolia University of Science and Technology Baotou Medical College First Affiliated Hospital， Baotou 014010， China
doi：10.3969/j.issn.1674-4985.2019.29.018
腦梗死是一种现实中非常常见的脑血管疾病，有较高的致残率与病死率，会严重影响了人的生命健康。人类将低温治疗技术应用在疾病治疗中的历史最早可以追溯到两千多年前的古埃及，那时人类就已经采用低温冷敷的方式进行止痛，并取得了比较好的效果[1-2]。一开始，低温在医学上的应用主要侧重于对冻伤的救治，至于低温治疗在脑部疾病上的应用，开始的比较晚，20世纪50年代左右，有国外的学者才在护脑复苏与脑保的领域采用低温治疗的研究，随之发现对大鼠的体温进行轻度降低也能减少因为缺血导致的神经细胞的死亡，而且其效果和深低温所产生的效果相同，更重要的是，这种温度下不会发生深低温作用下的并发症[3-5]。当前，在脑保护的研究医疗实践中，一般是采用28～35 ℃亚低温，特别是在一些医疗条件比较好的医院中，亚低温治疗方法已经被作为脑血管疾病以及重型颅脑损伤的常规辅助的治疗方法[6-8]。本文主要是对急性脑梗死动脉溶栓联合血管内低温灌注的研究，探讨亚低温对脑缺血性损害神经保护作用的可能机制。现报道如下。, http://www.100md.com(席富强 薛继娇)