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目的实施急性脑梗死规范化治疗,观察其临床疗效、降低病死率、并发症发生率及平均住院费用的效果,为急性脑梗死规范化治疗的推广提供依据。方法采用病例历史对照研究,对2004年7月～2005年7月符合纳入标准的急性脑梗死患者实施规范化治疗组成规范化治疗组,2003年6月～2004年6月同条件的已实施常规治疗的患者为对照,分别登记患者治疗前后美国国立卫生院神经功能缺损评分(NationalInstitutesofHealthStroke,NIHSS)、格拉斯哥昏迷评分(Glasgow-PittsburghComaScale,GCS)、日常生活行为能力Barthel指数,院内并发症发生率、院内病死率、平均住院费用等指标,进行统计分析比较两组差别。结果与常规组相比,规范组治疗后可显著降低患者NIHSS,提高Barthel指数,降低住院期间并发症的发生,尤其是肺部感染,院内病死率亦有显著降低(8.2%vs15.2%),住院期间平均费用规范组较常规组节省2000元左右,两组比较有显著性差异(P<0.05)。结论急性脑梗死规范化治疗可显著改善患者预后,降低病死率,降低住院费用,值得在基层医院大力推广。
Objective To standardize the treatment of acute cerebral infarction and observe its clinical efficacy, reduce mortality, the incidence of complications and the effect of average hospitalization costs, to provide a basis for the promotion of standardization of treatment of acute cerebral infarction. Methods A case-control study was conducted. Patients with acute cerebral infarction who met the inclusion criteria from July 2004 to July 2005 were enrolled in the standardization treatment group. From June 2003 to June 2004, patients undergoing routine treatment with the same conditions (National Institutes of Health Stroke, NIHSS), Glasgow-Pittsburgh Coma Scale (GCS), Barthel Index of daily living ability, incidence of nosocomial complications, and hospital mortality , Average hospitalization costs and other indicators, statistical analysis to compare the differences between the two groups. Results Compared with the conventional group, the NIHSS of patients in the standard group decreased significantly, the Barthel index increased, and the incidence of complications during hospitalization was decreased. In particular, pulmonary infection also showed a significant reduction in in-hospital mortality (8.2% vs 15.2%) , The average cost of hospitalization during the normative group than the regular group to save about 2000 yuan, the two groups were significantly different (P <0.05). Conclusion Standardized treatment of acute cerebral infarction can significantly improve patient prognosis, reduce mortality and reduce hospitalization costs, it is worth to promote in primary hospitals.