本文選題：急性腦梗死 + 丁苯酞氯化鈉注射液�。� 參考：《河北大學(xué)》2017年碩士論文

【摘要】：目的:觀察丁苯酞氯化鈉注射液對(duì)急性腦梗死患者治療作用的機(jī)制,并探討改善腦組織血流是否是丁苯酞治療急性腦梗死的機(jī)制。方法:選取我院60例急性腦梗死患者,采取數(shù)字表法隨機(jī)分為觀察組和對(duì)照組各30例,兩組患者均給予阿司匹林、阿托伐他汀等常規(guī)治療,觀察組在基礎(chǔ)治療上應(yīng)用丁苯酞氯化鈉注射液治療,兩組患者均連續(xù)治療14天,觀察兩組治療前后的療效,并采用美國國立衛(wèi)生研究院卒中量表(NIHSS)評(píng)價(jià)兩組患者治療前后的神經(jīng)功能缺損狀況。采用TCD屏氣試驗(yàn)檢測治療前后腦血流情況,對(duì)比兩組治療前、治療72小時(shí)、治療7天、治療14天的脈動(dòng)指數(shù)(PI)、屏氣指數(shù)(BHI)、平均血流速度(Vm)。結(jié)果:(1)觀察組總有效率90%,對(duì)照組總有效率76.67%,觀察組的總有效率明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(χ2=6.13,P0.01)。(2)治療后兩組患者NIHSS評(píng)分均顯著降低,與對(duì)照組相比,觀察組降低更明顯(t=3.118,P0.05)。(3)兩組患者治療前的PI、BHI、Vm對(duì)比均,差異無統(tǒng)計(jì)學(xué)意義(P0.05),治療后72小時(shí)、7天、14天兩組患者的PI有不同程度降低,BHI和Vm不同程度增高,兩組患者治療14天的PI、BHI、Vm對(duì)比,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其中對(duì)照組治療72小時(shí)、7天的PI、BHI、Vm與治療前相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05),治療組治療14天的PI、BHI、Vm與治療前相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組治療72小時(shí)的PI、BHI、Vm與治療前相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05),觀察組治療7天、14天的PI、BHI、Vm與治療72小時(shí)相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05),進(jìn)一步兩兩比較,治療72小時(shí)、7天的PI、BHI、Vm與治療14天相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:丁苯酞氯化鈉注射液用于急性腦梗死患者能夠更好的改善患者的腦血流狀況,減少患者的神經(jīng)功能缺損,加快腦組織修復(fù),對(duì)急性腦梗死的治療有明顯療效,臨床安全有效,且無明顯不良反應(yīng),值得在臨床上推廣和應(yīng)用。
[Abstract]:Objective: to observe the therapeutic effect of butyphthalide sodium chloride injection on patients with acute cerebral infarction and to explore whether improving the blood flow of brain tissue is the mechanism of butyphthalide in treating acute cerebral infarction. Methods: sixty patients with acute cerebral infarction in our hospital were randomly divided into observation group (n = 30) and control group (n = 30). The observation group was treated with butyphthalide sodium chloride injection in the basic treatment, and the two groups were treated continuously for 14 days. The curative effect of the two groups before and after treatment was observed. The National Institutes of Health Stroke scale (NIHSS) was used to evaluate the neurological impairment of the two groups before and after treatment. The cerebral blood flow before and after treatment was measured by TCD breath-holding test. The pulsation index (Pi), the breath-holding index (BHI), and the mean blood flow velocity (VMV) of 72 hours, 7 days and 14 days of treatment before and after treatment were compared between the two groups. Results the total effective rate was 90 in the observation group and 76.67 in the control group. The total effective rate in the observation group was significantly higher than that in the control group (蠂 ~ (2) 6.13) (P 0.01). The NIHSS scores of the two groups were significantly lower than those in the control group. There was no significant difference of Pi BHIV m between the two groups before treatment, there was no significant difference between the two groups. The Pi of the two groups increased in different degree after 72 hours, 7 days and 14 days after treatment, and the two groups had 14 days of treatment of PIBHIVm. The difference was statistically significant (P 0.05). In the control group, there was no significant difference in PIBHIVm between 72 hours and 7 days after treatment, but there was no significant difference between the treatment group and the treatment group after 14 days of treatment. There was a significant difference between the treatment group and the pre-treatment group (P 0.05). There was no significant difference in PIBHIVm between the observation group and the control group after 72 hours treatment (P 0.05), but there was no significant difference between the observation group and the 72 hours treatment group (P 0.05 vs 72 h), and there was no significant difference between the observation group and the 72 hours treatment group, and there was no significant difference between the observation group and the treatment group (P 0.05), and there was no significant difference between the observation group and the 72 hours treatment group (P 0.05). Compared with 14 days, the difference of PIBHIVm between 72 hours and 7 days was statistically significant (P 0.05). Conclusion: butyphthalide sodium chloride injection in patients with acute cerebral infarction can better improve the cerebral blood flow, reduce the neurological deficit of patients, accelerate the repair of brain tissue, and have obvious curative effect on the treatment of acute cerebral infarction. It is safe and effective in clinic and has no obvious adverse reaction, so it is worth popularizing and applying in clinic.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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