神经介入联合局部使用地塞米松对急性缺血性脑卒中患者预后的影响  

Influence of neurological intervention combined with dexamethasone injection on the outcome for the patients suffered from acute ischemic stroke

作　　者：张虎庭 罗赛华[2] 

机构地区：[1]广东医科大学,广东湛江524023 [2]廉江市人民医院神经外科,广东廉江524400

出　　处：《分子影像学杂志》2016年第2期121-124,共4页Journal of Molecular Imaging

基　　金：广东省科技厅产业技术研究与开发资金计划项目(2011B031800048)

摘　　要：目的探讨神经介入联合局部使用地塞米松治疗急性缺血性脑卒中(AIS)的疗效及安全性。方法入选60例AIS患者随机分为地塞米松组(A组)、生理盐水组(B组)及单纯介入组(C组),每组各20例。比较3组术后神经功能评分、脑组织相对表观弥散系数、内分泌及并发症例数等。结果 A组术后1月神经功能评分明显低于B及C组(P<0.05);A组术后第3天脑组织相对表观弥散系数明显高于B及C组,而术后1月最终脑体积明显低于B及C组;术后第1天3组间血清皮质醇含量均无统计学意义(P>0.05);3组间术后并发症例数构成均无统计学差异(P>0.05)。结论神经介入联合局部使用地塞米松治疗可减轻AIS患者脑水肿并降低脑梗死体积,且不影响神经内分泌、不增加患者发生并发症风险,有助于改善AIS患者的预后。Objective To observe the influence of neurological intervention combined with dexamethasone injection on the outcome for the patients suffered from acute ischemic stroke. Methods Sixty patients with AIS were randomly divided into the dexamethasone group（group A）, normal saline group（group B） and the simple intervention group（group C）, with 20 cases in each group. Three groups were compared of postoperative neurological function score（NIHSS） scores, brain tissue relative apparent diffusion coefficient（r ADC）, endocrine and complications such as the number of cases. Results NIHSS score of group A was lower than that in group B and C（P〈0.05） after January; A group was significantly higher than that of group B and C in postoperative day 3 r ADC, and the final brain volume was lower than that in group B and C after 1 month; serum cortisol levels between the 3 groups had no significant difference（P〉0.05） at postoperative day 1; The postoperative complications between the 3 groups of cases constitute had no significant difference（P〉0.05）. Conclusion Nerve involvement with local use of DXM therapy can relieve cerebral edema and AIS patients reduced cerebral infarction volume, can not affect the neuroendocrine, does not increase a patient’s risk of complications, and help to improve the prognosis of patients with AIS.

关 键 词：缺血性脑卒中 脑保护 糖皮质激素 神经介入 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]