脑卒中急性期NFDS与颅内压、脑灌注压、血压变化的相关性  

Research of relationship between neurological functional deficit scale and changes of intracranial pressure,cerebral perfusion pressure and blood pressure in apoplexy patients during acute stage

作　　者：廖琦[1] 周冀英[1] 谭戈[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,400016

出　　处：《重庆医学》2007年第9期812-814,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(30370493);重庆市卫生局重点资助项目(99-1001)

摘　　要：目的前瞻性地观察急性期卒中患者的颅内压（ICP）、脑灌注压（CPP）及血压（BP）水平,探讨与临床神经功能恢复程度的关系,为临床制定最佳治疗方案提供帮助。方法对62例脑梗死患者及41例脑出血患者的临床神经功能缺损程度评分（NFDS）及对CPPI、CP、BP进行7~14d的动态观察,采用多元逐步回归方法分析患者临床NFDS的变化与CPPI、CP及BP变化率之间的相关性,以确定与评分变化率最为密切相关的因素。结果脑梗死患者急性期临床神经功能的恢复与CPP的改善密切相关（P〈0.05）,而脑出血患者神经功能的恢复与ICP的控制密切相关（P〈0.05）。结论急性脑梗死的治疗重点应放在改善脑灌注上,而脑出血急性期则应更注意ICP的控制。血压在急性期并不是临床神经功能恢复程度的独立影响因子。Objective To observe ICP, CPP and BP of the stroke patients prospectively during acute stage, and to seek the clinical factors which are significant for the degree of neurological function recovery in order to guide doctors to make a therapeutic strategy. Methods One hundred three patients were selected for the study. Among them,62 cases were cerebral infarction（CI） and 41 cases were intracerebral hemorrhage（ICH）. The neurological functional deficit scale（NFDS） was used to score the neuroligical impairment of patients, and the ICP, BP, CPP were monitored for 7-14d. The relationship between the extent of alteration of neurological impairment and the clinical factors were analyzed with multiple stepwise regression. Results The extent of alteration of CPP was independently associated with the extent of alteration of neurological functional deficit score in CI. In ICH patients, the extent of alteration of ICP pressure was independently associated with the extent of alteration of neuroligical functional deficit score. Conclusion Different therapeutic regimes should be selected for ICH patients and CI patients. For CI patients, the emphasis should be put on the improvement of CPP, and for ICH patients, the control of ICP is more important.

关 键 词：脑卒中 神经功能缺损程度评分 颅内压 脑灌注压 

分 类 号：R743.3[医药卫生—神经病学与精神病学]