本文選題：腦梗死 + 昏迷�。� 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的觀察泰舒達（trastal）聯(lián)合小腦頂核電刺激（fastigial nucleusstimulation，F(xiàn)NS）治療急性腦梗死昏迷患者的臨床療效。 方法90例急性腦梗死昏迷患者隨機分為3組，對照組1、對照組2、治療組，每組30例。對照組1接受腦梗死伴昏迷的常規(guī)治療，對照組2接受“常規(guī)治療+小腦頂核電刺激”治療，治療組接受“常規(guī)治療+泰舒達+小腦頂核電刺激”治療。在治療前、治療后7d、14d、21d，分別采用格拉斯哥昏迷量表（Glasgow coma scale，GCS）和美國國立衛(wèi)生院神經(jīng)功能缺損評分(National Institutes of Health Stroke Scale，NIHSS)評定昏迷及神經(jīng)功能缺損程度。3組療程均為21天，治療21d后進行臨床療效評定。 結(jié)果治療7d后，3組患者分別與各自基線水平比較，，臨床癥狀改善但GCS及NIHSS評分無統(tǒng)計學(xué)差異（P0.05）。治療l4d、21d后，3組患者GCS及NIHSS評分較基線水平均明顯改善(P0.05)；治療組GCS及NIHSS評分顯著優(yōu)于對照組1(P0.01)；與對照組2比較，治療組GCS及NIHSS評分趨勢好轉(zhuǎn)（治療14d、21d后，治療組GCS評分均高于對照組2，NIHSS評分均低于對照組2），但統(tǒng)計學(xué)分析未見顯著差異（P0.05）。3組患者在治療21天后，進行臨床療效評定，淺昏迷、中度昏迷的患者促醒效果較好，而深昏迷患者基本無效。總體有效率：治療組、對照組1、對照組2分別為93.3%、73.3%、86.7%。 結(jié)論在急性腦梗死伴昏迷患者的常規(guī)治療基礎(chǔ)上，單純加用小腦頂核電刺激治療，其GCS及NIHSS評分可有好轉(zhuǎn)趨勢，但統(tǒng)計學(xué)差異不顯著；而采用“泰舒達+小腦頂核電刺激”的聯(lián)合治療方案，則可顯著改善輕、中度腦梗死昏迷患者的意識狀態(tài)及神經(jīng)功能缺損癥狀。
[Abstract]:Objective to observe the clinical effect of Tesustal combined with fastigial nucleus stimulation (FNSs) in the treatment of coma patients with acute cerebral infarction. Methods 90 patients with acute cerebral infarction coma were randomly divided into 3 groups: control group (1), control group (2), treatment group (30 cases). Control group 1 received routine treatment of cerebral infarction with coma, control group 2 received "routine treatment of cerebellar fastigial nuclear stimulation" and treatment group received "routine treatment of Tessuda cerebellar fastigial nuclear stimulation". Before and after treatment, Glasgow coma scale (Glasgow coma scale) and National Institutes of Health Stroke scale (NIHSS) were used to evaluate the severity of coma and neurological impairment for 21 days. The clinical efficacy was evaluated after 21 days of treatment. Results after 7 days of treatment, the clinical symptoms were improved, but there was no significant difference in the scores of GCS and NIHSS between the three groups compared with their baseline level (P 0.05). The scores of GCS and NIHSS in the treatment group were significantly better than those in the baseline level, the scores of GCS and NIHSS in the treatment group were significantly better than those in the control group (P 0.01), compared with the control group, the GCS and NIHSS scores in the treatment group were better than those in the control group (14 days and 21 days after treatment), and the scores of GCS and NIHSS in the treatment group were better than those in the control group (14 days and 21 days after treatment). The GCS score of the treatment group was higher than that of the control group (2NIHSS), but there was no significant difference between the two groups. But the deep coma patient basically has no effect. The total effective rate: treatment group, control group 1, control group 2 were 93.33.3and 86.7, respectively. Conclusion on the basis of routine treatment in patients with acute cerebral infarction and coma, the GCS and NIHSS scores of patients with acute cerebral infarction combined with coma can be improved, but there is no significant difference in GCS and NIHSS scores. The combined treatment of "Texuda cerebellar fastigial nuclear stimulation" can significantly improve the consciousness state and neurological deficit in patients with mild and moderate cerebral infarction.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R743.33

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