本文選題：缺血性腦卒中 + 肺部感染　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：缺血性腦卒中往往合并系統(tǒng)性并發(fā)癥,延長(zhǎng)了住院時(shí)間,增加經(jīng)濟(jì)負(fù)擔(dān),使死亡率進(jìn)一步升高。尋找行之有效的措施預(yù)防和治療合并肺部感染的腦梗塞具有重要臨床意義。研究目的:觀察丹參多酚酸治療合并肺部感染的急性輕中度腦梗塞患者治療前,治療2周后,3個(gè)月后神經(jīng)功能缺損評(píng)分(NIHSS評(píng)分)及三個(gè)月后日常生活能力(ADL評(píng)分)變化,探討應(yīng)用丹參多酚酸治療腦梗塞合并肺部感染的臨床療效。研究方法:將合并肺部感染的急性輕中度腦梗塞患者110例隨機(jī)分為2組,肺部感染用藥組給予注射用丹參多酚酸,肺部感染非用藥組作為常規(guī)治療組。另選55例不合并肺部感染的急性輕中度腦梗塞患者作為腦梗塞用藥組,同樣給予丹參多酚酸治療。分別評(píng)價(jià)各組患者治療前、治療后2周,治療后3個(gè)月神經(jīng)功能缺損評(píng)分(NIHSS評(píng)分)及治療3個(gè)月的日常生活能力(Activities of Daily Living ADL)。每組均給予相同的基礎(chǔ)治療:舒血寧注射液,肌氨肽苷注射液,以及支持治療包括高血壓、糖尿病、高血脂等治療。肺部感染用藥組及常規(guī)治療組均給予敏感抗生素治療肺部感染。研究結(jié)果:1.肺炎用藥組、常規(guī)治療組和腦梗塞用藥組2周時(shí)間點(diǎn)NIHSS評(píng)分較入院時(shí)均降低,具有統(tǒng)計(jì)學(xué)差異(P0.05);肺炎用藥組與常規(guī)治療組2周時(shí)間點(diǎn)NIHSS評(píng)分比較,肺炎用藥組下降更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);肺炎用藥組和腦梗塞用藥組2周時(shí)間點(diǎn)NIHSS評(píng)分比較,腦梗塞用藥組下降更明顯,二者比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。肺炎用藥組與常規(guī)治療組3個(gè)月NIHSS評(píng)分比較,肺炎用藥組NIHSS評(píng)分下降明顯,二者之間的差異具有統(tǒng)計(jì)學(xué)意義(P0.05);肺炎用藥組與腦梗塞用藥組于3個(gè)月時(shí)間點(diǎn)NIHSS評(píng)分均下降,二者之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.肺炎用藥組與常規(guī)治療組3個(gè)月ADL評(píng)分比較,肺炎用藥組3個(gè)月時(shí)間點(diǎn)ADL評(píng)分高于常規(guī)治療組,具有統(tǒng)計(jì)學(xué)差異(P0.05);肺炎用藥組與腦梗塞用藥組3個(gè)月ADL評(píng)分比較,肺炎用藥組ADL評(píng)分稍高于腦梗塞用藥組,但二者之間的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.三組患者2周時(shí)監(jiān)測(cè)血常規(guī)、尿常規(guī)、凝血常規(guī)、心肌酶等,其結(jié)果與入院時(shí)相比未見(jiàn)明顯異常,于用藥期間并無(wú)異常癥狀出現(xiàn)。結(jié)論:1.急性期加用丹參多酚酸能夠改善患者3個(gè)月神經(jīng)功能及日常生活能力。2.肺部感染延遲急性輕中度腦梗塞2周時(shí)間點(diǎn)神經(jīng)功能恢復(fù),但不影響3個(gè)月后神經(jīng)功能恢復(fù)及日常生活能力。3.注射用丹參多酚酸能夠改善合并肺部感染的急性輕中度缺血性腦卒中的神經(jīng)功能和日常生活能力,對(duì)合并肺部感染的腦梗塞有效。
[Abstract]:Ischemic stroke often complicates systemic complications, prolongs hospital stay, increases economic burden and further increases mortality.It is of great clinical significance to find effective measures to prevent and treat cerebral infarction complicated with pulmonary infection.Objective: to observe the effects of salvia miltiorrhiza polyphenolic acid on acute mild to moderate cerebral infarction patients with pulmonary infection before, 2 weeks and 3 months after treatment.To investigate the clinical effect of salvia miltiorrhiza polyphenolic acid in the treatment of cerebral infarction complicated with pulmonary infection.Methods: 110 patients with acute mild and moderate cerebral infarction complicated with pulmonary infection were randomly divided into two groups: the drug group of pulmonary infection was given salvia miltiorrhiza polyphenolic acid for injection and the group of non-medication for pulmonary infection was used as routine treatment group.Another 55 patients with acute mild to moderate cerebral infarction without pulmonary infection were treated with salvia miltiorrhiza and polyphenolic acid.Before treatment, 2 weeks after treatment and 3 months after treatment, the neurological deficit score (NIHSS) and activities of Daily Living (ADL) were evaluated in each group.Each group was given the same basic treatment: Shuxuening injection, carnosine injection, and supportive therapy including hypertension, diabetes, hyperlipidemia and so on.Lung infection group and routine treatment group were given sensitive antibiotics to treat pulmonary infection.The result of the study was: 1.The scores of NIHSS at 2 weeks in the treatment group, routine treatment group and cerebral infarction group were significantly lower than those in the admission group (P 0.05), and the NIHSS scores at the 2 week point in the pneumonia medication group were significantly lower than those in the routine treatment group.The difference was statistically significant (P 0.05), and the NIHSS score at 2 weeks in the pneumonia group and the cerebral infarction group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P 0.05).Compared with the routine treatment group, the NIHSS score of the pneumonia medication group decreased significantly, the difference between the two groups was statistically significant (P 0.05), the NIHSS score of the pneumonia medication group and the cerebral infarction group decreased at 3 months.There was no significant difference between the two groups (P 0.05. 2).Compared with the routine treatment group, the 3-month ADL score of the pneumonia medication group was higher than that of the routine treatment group at 3 months, and the ADL score of the pneumonia medication group and the cerebral infarction group was higher than that of the routine treatment group (P 0.05).The ADL score of pneumonia group was slightly higher than that of cerebral infarction group, but there was no significant difference between the two groups (P 0.05. 3).The blood routine, urine routine, coagulation routine and myocardial enzyme were monitored in the three groups at 2 weeks. The results were not significantly abnormal compared with those on admission, and no abnormal symptoms appeared during the treatment period.Conclusion 1.Salvia miltiorrhiza polyphenolic acid in acute phase can improve the neurological function and ADL of the patients for 3 months.Pulmonary infection delayed the recovery of nerve function at 2 weeks after acute mild to moderate cerebral infarction, but did not affect the recovery of nerve function and activity of daily living after 3 months.Salvia miltiorrhiza polyphenolic acid for injection can improve the neurological function and daily living ability of acute mild to moderate ischemic stroke complicated with pulmonary infection and is effective for cerebral infarction complicated with pulmonary infection.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R743.33;R563.1

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