由玮 石磊 林晶倩 姜佳丽

[摘要] 目的 探討大面积脑梗死急性期后患者采取丁苯酞序贯的临床疗效。 方法 收集2018年1月至2019年12月我院神经内科收治的大面积脑梗死急性期后患者64例，按照随机数字表法分为对照组和观察组，每组各32例，对照组采取常规治疗，观察组在对照组基础上联合丁苯酞注射液序贯治疗，比较两组NIHSS评分、临床疗效、CVR、MFV水平。 结果 治疗前、治疗后6 h，两组NIHSS评分比较，差异无统计学意义（P>0.05），治疗后24 h、7 d观察组NIHSS评分低于对照组，差异有统计学意义（P<0.05）;观察组治疗总有效率为90.63%，高于对照组的78.13%，差异有统计学意义（P<0.05）;治疗前，两组CVR、MFV水平比较，差异无统计学意义（P>0.05），治疗后，观察组CVR、MFV水平高于对照组，差异有统计学意义（P<0.05）。 结论 丁苯酞序贯治疗大面积脑梗死急性期后患者，可降低致残率，改善神经功能，提高临床疗效，值得临床应用。

[关键词] 大面积脑梗死急性期;丁苯酞;神经功能;致残率

[中图分类号] R743.33          [文献标识码] B          [文章编号] 1673-9701（2021）07-0042-04

Clinical effect of sequential therapy of butylphthalide in the treatment of large area cerebral infarction in acute stage

YOU Wei   SHI Lei   LIN Jingqian   JIANG Jiali

Department of Neurology，Yantai Laiyang Central Hospital in Shandong Province， Laiyang   265200，China

[Abstract] Objective To explore the efficacy of sequential treatment with butylphthalide after acute cerebral infarction. Methods Sixty-four patients with acute cerebral infarction in our hospital from January 2018 to December 2019 were collected and randomly divided into two groups， with 32 cases in each group. The control group received routine treatment，while the observation group received sequential treatment with butylphthalide injection on the basis of the control group. The NIHSS score，clinical efficacy， the level of CVR， MFV were compared between the two groups. Results There was no significant difference of NIHSS scores between the two groups before the treatment and 6 hour after the treatment（P>0.05）， but the NIHSS scores in the observation group at 24 h and 7 d after treatment were lower than those in the control group， and the difference between the two groups was statistically significant （P<0.05）. The total effective rate in the observation group was 90.63%，which was higher than that of 78.13% in the control group，and the difference between the two groups was statistically significant（P<0.05）. There was no significant difference in CVR and MFV levels between the two groups（P>0.05）. After treatment， CVR and MFV levels in the observation group were higher than those in the control group，with significant difference between the two groups（P<0.05）. Conclusion Butylphthalide sequential treatment can reduce disability rate， improve neurological function and improve clinical efficacy of patients with massive cerebral infarction after acute stage，which is worthy of application.

[Key words] Acute stage of massive cerebral infarction; Butylphthalide; Neurological function; Disability rate

脑梗死作为临床常见一类神经系统疾病，特点为高发病率、高病死率及高致残率。患者因脑局部供血动脉血流减少或中断，引起相应区域脑组织缺血、缺氧性损伤。若血流阻滞时间较长，脑细胞长时间缺血会形成不可逆转的坏死性损伤[1]。大面积脑梗死患者临床症状包括头痛、失语、恶心呕吐、肢体瘫痪及程度不同的意识障碍等。该类患者起病急，病情严重，治疗后生活质量偏低，急性期死亡率偏高。因此，急性大面积脑梗死患者早期恢复脑组织供血动脉血流可挽救部分损伤的脑细胞，对预后起着积极作用。丁苯酞作为一类改善脑组织代谢用药，可使梗死区血流量增加并缩小梗死面积，减轻神经功能损伤。有研究指出[2]，在急性脑梗死患者中应用丁苯酞疗效显著，具有一定临床价值。本研……