脑电地形图在缺血性半影区的研究

STUDY ON BEAM IN ISCHEMIC PENUMBRA REGION

目的:治疗缺血性脑梗塞的关键是尽早恢复缺血性半影区的功能,缩小梗塞体积,通过临床实验,研究了缺血性半影区的影响因素,功能恢复的检测指标,最佳治疗时间窗和治疗方法,以达到降低缺血性脑梗塞的致残率和死亡率,提高治愈率的目的。方法:选择确诊为颈内动脉系统梗塞的住院患者69例。按发病及就诊的时间不同随机分为两组,即早治组(发病后12小时内开始治疗)和对照组(发病后12～72小时开始治疗),两组患者治疗方法相同,均给予溶栓疗法,钙离子阻滞剂,自由基清除剂以及综合治疗措施,一周后判断疗效;治疗前后除评估神经功能缺损积分的多少外,69例患者均检查血压,体温,血脂,肝肾功能,脑CT,脑电地形图检查,部分患者作了脑ECT检查。结果:通过临床研究发现早治组的疗效明显优于对照组,两组对比,有显著性差异(P<0.01)。早治组表现为:(1)治疗后神经功能缺损积分明显下降,两组治疗后平均积分差为6.13±4.65。(2)脑CT显示病变区边界清楚,范围有不同程度的缩小,对周围脑组织的影响消失。(3)脑电地形图显示,病变区及周围缺血性半影区慢波频带功率值下降,病变范围缩小,脑ECT也显示病变范围缩小。(4)副作用小,无一例患者出现继发性出血性脑损害,明显优于对照组。结论:通过本研究,我们得出以下结论:(1)

PURPOSE-The key of treatment of ischemic cerebral infarctiom was to recover the functions of ischemic penumbra region (IPR) as early as possible so that the infarction volume was reduced.In order to decrease disabled rate,mortality and increase cure rate of cerebral infarction,the influence factors,examining indexes,best therapeutic time window and methods of ischemic penumbra region were studied in this paper.METHODS;69 patients with infarctions of internal carotid artery system were investigated clinically and randomly divided into two groups according to different treatment time-eraly treatment group ( treatment in 12 hours ) and control group ( treatment in 12~72 hours ).Two groups patients were treated with the same drug-therapy and their results were evaluated in 7 days.They were examined blood pressure,temperature,blood lipid,liver and renal funcrions,brain electrical activity mapping ( BEAM ) and brain computed tomography ( CT ) besides evaluating nervous function lesion scores before and after treatment.A few patients were also examined brain emission computed tomography ( ECT ).RESULTS:The therapeutic effect of early treatment group was higher than that of the control group.(1) The nervous function scores were reduced obviously after treatment,the difference of mean score between two groups was 6.13+4.65.there was significant differernce between two groups.(2) Brain CT showed that the hypodensity shadow with clear border was lessened in various degrees and the influence of around brain tissues was disappeared.(3) Brain electrical activity mapping showed that the ischemic infarction region a0d ischemic penumbra region became smaller and the powers were decreased in slow waves significantly.(4) Side effects such as secondary hemorrhagic damage were not found in early treatment group.CONCLUSION;The study demonstrated;(1) The key of treatment on the ischemic cerebral infarction was to recover the functions of ischemic penumbra region as early as possible so as to reduce infarction volume and improve prognosis.(2) The best therapeutic time window of ischemic penumbra region was in 12 hours after ischemic onset.(3) The therapy to recover ischemic penumbra region functions was synthetic treatment measures that was described in this paper.(4) Brain electrical activity mapping and brain emission computed tomography were better indexes in evaluating the functions of ischemic penumbra region.