急性脑梗死患者脑水肿程度与意识障碍的量化关系  

THE QUANTITIVE RELATIONSHIP BETWEEN BRAIN EDEMA AND CONSCIOUSNESS DISORDERS IN PATIENTS WHITH ACUTE CEREBRAL INFARCTION

作　　者：张璇[1] 元小冬[2] 王淑娟[2] 刘顺莉[2] 吴宗武[2] 周立富[2] 张丽丽[2] 吕淑娟[2] 王京[2] 

机构地区：[1]山西医科大学汾阳学院,山西省汾阳市032200 [2]河北联合大学附属开滦总医院神经内科

出　　处：《中国煤炭工业医学杂志》2015年第1期17-19,共3页Chinese Journal of Coal Industry Medicine

基　　金：2013年河北省医学适用技术跟踪项目(编号:GL201304)

摘　　要：目的应用无创性脑水肿监测技术观察急性脑梗死患者脑水肿的变化特征,从而指导临床脑水肿的脱水治疗。方法选择急性单侧脑梗死患者22例,并记录患者的意识状态、APACHEⅡ评分、死亡风险系数、Glasgow评分、血液生化和血气分析等相关指标。同时,采用BOEN-BE无创性脑水肿动态监护仪按说明书进行双侧大脑半球扰动系数值的连续多时相点动态测定。结果 22例急性脑梗死患者大脑半球梗死病灶侧扰动系数与非病灶侧比较差异无统计学意义(11.99±2.56、11.98±2.56,P=0.99),3例死亡患者与19例预后非死亡患者的大脑病灶侧扰动系数比较差异无统计学意义(12.68±1.99、11.88±2.67,P=0.63),20例发生意识障碍患者与2例正常意识者的大脑病灶侧扰动系数比较差异无统计学意义(11.95±2.67、12.36±1.56,P=0.84)。单因素和多因素分析均未发现大脑病灶侧扰动系数与发病时间、意识状态、死亡有明显的相关性。结论急性脑梗死患者一般不发生严重的脑水肿,但应特别重视患者的营养状态,防止低蛋白血症的发生,对于特殊患者应结合适时动态监测结果制定个体化的脱水治疗方案。Objective To observe the cerebral edema characteristics of acute cerebral infarction patients so as to guide clinical treatment of cerebral edema by BORN -BE non-invasion brain edema monitor technol‐ogy .Methods A total of 22 unilateral cerebral infarction patients were selected ,and consciousness ,A‐PACHEⅡscore ,mortality risk factor related indicators ,Glasgow score ,blood biochemistry and blood gas analysis of patients were recorded .Meanwhile ,BOEN -BE non-invasive brain edema monitor technology was used to detect the disturbance coefficient values of continuous multi -temporal point of both hemi‐spheres dynamically .Results In 22 cases of acute cerebral infarction ,disturbance coefficient values of ipsi‐lateral cerebral hemisphere infarction and non - lesion side had no difference （11 .99 ± 2 .56 ,11 .98 ± 2 .56 , P=0 .99） ,disturbance coefficient values of 3 dead patients and 19 non -dead patients with brain lesions had no difference （12 .68 ± 1 .99 ,11 .88 ± 2 .67 , P=0 .63） ,disturbance coefficient values of 20 conscious‐ness disorders patients and 2 normal patients with brain lesions had also no difference （11 .95 ± 2 .67 ,12 .36 ± 1 .56 ,P=0 .84） .There were no significant correlation between disturbance coefficient values of brain le‐sions and time of onset ,state of consciousness ,death using univariate and multivariate analysis .Conclu‐sions Severe brain edema do not occur in patients with acute cerebral infarction generally ,but it should pay special attention to the nutritional status of patients to prevent the occurrence of hypoproteinemia .We should develop individualized treatment programs for particular patients combined with timely and dynamic non-invasion brain edema monitor results .

关 键 词：急性脑梗死 脑水肿 无创脑水肿动态监护仪 综合扰动系数 

分 类 号：R743.9[医药卫生—神经病学与精神病学]