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目的探讨肢体缺血后处理治疗急性脑梗死的临床疗效。方法选择2015年3月~2016年6月在我院住院治疗的158例未进行溶栓治疗的急性脑梗死(发病72 h内)患者作为研究对象,所有患者均经影像证实,按照入院先后顺序随机分为治疗组和对照组。所有患者均给予常规治疗,治疗组在常规治疗的基础上给予4个短周期单侧上肢缺血再灌注,每天进行1次连续7 d。比较入院时和病程14 d时两组患者的临床疗效;入院时、病程14 d和病程3 m时的美国国立卫生研究院卒中量表(NIHSS)和磁共振灌注加权成像(PWI);入院时和病程3 m时的改良Rankin量表(mRS)、梗死体积。结果治疗14 d后,治疗组总有效率(95.9%)高于对照组(79.0%),差异有统计学意义(P<0.05);两组患者NIHSS评分、rMTT在入院时和病程14 d时差异无统计学意义,均在病程3 m时差异有统计学意义(P<0.05);病程3 m时,治疗组mRS较对照组下降(P<0.05),治疗组梗死体积较对照组减小(P<0.05)。结论在急性脑梗死患者常规治疗的基础上给予短暂性肢体缺血后处理治疗,可以提高患者的临床疗效,减轻NIHSS评分及mRS评分,减小梗死体积,增加脑灌注。
Objective To investigate the clinical effect of limb ischemic postconditioning on acute cerebral infarction. Methods A total of 158 patients with acute cerebral infarction (within 72 hours of onset) who were treated in our hospital from March 2015 to June 2016 were enrolled in this study. All patients were confirmed by imaging and according to the order of admission Randomly divided into treatment group and control group. All patients were given routine treatment. The treatment group was given 4 short-term unilateral upper limb ischemia-reperfusion on the basis of routine treatment, once a day for 7 consecutive days. The clinical efficacy was compared between the two groups on admission and on the 14th day of disease. NIHSS and PWI were recorded at 14 days of admission and at 3 months of disease duration. At admission And modified Rankin scale (mRS) at 3 m duration, infarct volume. Results After treatment for 14 days, the total effective rate (95.9%) in the treatment group was significantly higher than that in the control group (79.0%) (P <0.05). NIHSS score and rMTT in the two groups were significantly higher at admission and at 14 days (P <0.05). When the course of disease was 3 m, the mRS of the treatment group was lower than that of the control group (P <0.05), and the volume of infarction in the treatment group was lower than that of the control group (P <0.05). Conclusion The treatment of acute limb ischemic postconditioning on the basis of routine treatment of patients with acute cerebral infarction can improve the clinical curative effect, reduce the NIHSS score and mRS score, reduce the infarct volume and increase the cerebral perfusion.