急性缺血性脑卒中静脉溶栓后脑水肿发生情况及影响因素分析  

Incidence and Influencing Factors Analysis of Cerebral Edema of Acute Ischemic Stroke After Intravenous Thrombolysis

作　　者：刘斌[1] 李旺春 欧鸿儒 LIU Bin;LI Wangchun;OU Hongru(ICU Department,Jinan University Affiliated Shunde Hospital,Shunde,Guangdong 528305)

机构地区：[1]暨南大学附属顺德医院重症医学科,广东顺德528305

出　　处：《智慧健康》2023年第31期41-44,48,共5页Smart Healthcare

摘　　要：目的探讨急性缺血性脑卒中静脉溶栓后脑水肿发生情况并分析其影响因素。方法选取2021年1月—2022年3月佛山市顺德区暨南大学附属顺德医院拟行静脉溶栓术的40例急性缺血性脑卒中患者作为研究对象,根据静脉溶栓后24h内多模式CT扫描,分为水肿组和无水肿组。结果单因素分析显示,以静脉溶栓是否导致脑水肿为因变量时,年龄、发病至溶栓前时间、溶栓前收缩压、溶栓前NIHSS评分以及白细胞计数在静脉溶栓过程中对脑水肿的发生产生影响对比无水肿组差异有统计学意义(P<0.05)。将有意义的影响因素作为因变量,使用Logistic回归进一步分析出溶栓前收缩压和溶栓前NIHSS评分是发生脑水肿的危险因素。结论脑水肿在研究对象中的发生率达到了50%,溶栓前收缩压和溶栓前NIHSS评分是导致急性缺血性脑卒中患者发生脑水肿的独立危险因素。Objective To explore occurrence of cerebral edema of acute ischemic stroke after intravenous thrombolysis and analyze its influencing factors.Methods The paper chose 40 patients with acute ischemic stroke with intravenous thrombolysis at Jinan University affiliated Foshan City Shunde District Shunde Hospital from January 2021 to March 2022 as study subjects,and divided them into edema group and anhydrous edema group based on multimodal CT scans within 24 hours after intravenous thrombolysis.Results Univariate analysis showed,with dependent variable of intravenous thrombolysis caused brain edema,age,time from onset to pre thrombolysis,pre thrombolysis systolic blood pressure,pre thrombolysis NIHSS scores,and white blood cell count had statistically significant effect on occurrence of brain edema during intravenous thrombolysis compared with without edema group(P<0.05).With dependent variable of logistic regression,meaningful influencing factors analysis further showed,pre thrombolytic systolic blood pressure and pre thrombolytic NIHSS scores were risk factors of developing cerebral edema.Conclusion Incidence of cerebral edema in study subjects reached 50%,and pre thrombolytic systolic blood pressure and pre thrombolytic NIHSS scores are independent risk factors for cerebral edema of patients with acute ischemic stroke.

关 键 词：缺血性脑卒中 脑水肿 静脉溶栓 影响因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]