【作者】 郭雅琴；

【导师】 张小宁；

【作者基本信息】 新疆医科大学 ， 神经病学， 2011， 硕士

【摘要】 目的：急性脑梗死是严重威胁人类生命与健康的疾病之一,严重影响着人们生活质量。该研究探讨急性脑梗死危险因素、住院期间医疗观察指标以及住院期间治疗,为急性脑梗死的预防及治疗提供依据。方法：采用回顾性调查方法分析1999年与2009年在新疆医科大学第一附属医院住院的急性脑梗死患者的资料,运用SPSS13.0统计软件包进行统计分析,构成比比较采用χ2检验,P<0.05有统计学意义。结果：(1)急性脑梗死1999年与2009年年龄构成比无统计学差异(P>0.05)；两组性别构成比有统计学差异(P<0.05)。(2)1999年与2009年急性脑梗死患者民族构成比无统计学差异(P>0.05)。(3)1999年与2009年急性脑梗死患者既往高血压病、糖尿病、心脏病、饮酒史构成比有统计学差异(P<0.05),既往脑卒中和吸烟史无统计学差异(P>0.05)。(4)2009年检测纤维蛋白原、空腹血糖、血脂、肝功、肾功、心电图、胸片、动态血压、动态心电图、心脏超声、颈部超声、TCD、MRI、DSA、免疫、腹部超声患者构成比高于1999年(P<0.05)。1999年未检测D-二聚体、CRP、同型半胱氨酸、CTA、MRA。2009年未检测血粘度、血沉。(5)2009年使用阿司匹林、预防应激性溃疡、预防感染、抗凝、脱水降颅压、降血压、调脂、降血糖患者构成比高于1999年(P<0.05)。结论：(1)急性脑梗死主要危险因素为血浆纤维蛋白原增高、高血压病、血脂异常、吸烟、血糖增高、血常规异常、饮酒史等。2009年对于危险因素的筛查较1999年有所提高。(2)2009年医疗观察检测指标较1999年增多,但观察检测指标尚存在部分缺陷,应加强CRP、同型半胱氨酸、颈部血管超声的检测,注意动脉粥样硬化的筛查。(3)2009年阿司匹林片、氯吡格雷片的使用、预防应激性溃疡、预防感染等并发症的治疗以及早期康复的治疗较1999年明显提高,更有助于患者生活质量的改善。更多还原

【Abstract】 Objective:Acute cerebral infarction is a serious threat to human life and health of one of the diseases, a serious impact on quality of life. The study of risk factors for acute cerebral infarction during hospitalization period of medical observation and inpatient treatment targets for the prevention of acute cerebral infarction and therapy. Methods: Retrospective analysis of survey methodology in 1999 and 2009, the First Affiliated Hospital of Xinjiang Medical University, acute cerebral infarction data, using statistical package for statistical analysis SPSS 13.0, proportion compared using X2 test, P<0.05 statistically significant. Results:(1) acute cerebral infarction in 1999 and 2009 was no significant difference in age composition ratio (P>0.05); the two groups weresignificantly different than the gender composition (P<0.05). (2) 1999 and 2009 the ethnic composition of patients with acute cerebral infarction than those without significant difference (P> 0.05). (3) 2009,1999 and previous hypertension in patients with acute cerebral infarction, diabetes, heart disease, history of drinking constitutes a significant difference compared (P <0.05), previous stroke, and smoking history was no significant difference (P>0.05). (4) 2009 Fibrinogen, fasting glucose, lipids, liver function, renal function, electrocardiogram, chest radiograph, blood pressure, electrocardiogram, cardiac ultrasound, neck ultrasound, TCD, MRI, DSA, immunity, patients with abdominal ultrasound constitute ratio higher than in 1999 (P<0.05). Not detected in 1999, D-dimer, CRP, homocysteine, CTA, MRA. Not detected in 2009 blood viscosity, erythrocyte sedimentation rate. (5) 2009, use of aspirin to prevent stress ulcers, prevention of infection, coagulation, dehydration reduce intracranial pressure, blood pressure, lipid, lower blood sugar in patients with proportions higher than in 1999 (P<0.05). Conclusions:(1) the major risk factors for acute cerebral infarction plasma fibrinogen increased, hypertension, dyslipidemia, smoking, blood sugar, blood abnormalities, history of drinking and so on.2009, screening for risk factors has increased compared to 1999. (2) detection of indicators of medical observation in 2009 compared to 1999 increased, but there are still part of the observed defect detection index, should strengthen the CRP, homocysteine, and neck vascular ultrasound testing, attention atherosclerosis screening. (3) 2009, aspirin, clopidogrel tablets use of stress ulcer prevention, prevention of infection and other complications of treatment and early rehabilitation therapy significantly improved over 1999, but also help the quality of life of patients improvement.更多还原