The Distribution Of Cerebral Water Stasis Syndrome In Patients With Massive Cerebral Infarction And The Fluid Intake Related To Brain Edema

Objective1.The relationships of the early fluid intake and acute middle cerebral artery blood supply zone in patients with large area cerebral infarction malignant brain edema were not clear,the purpose of this study was to investigate the acute middle cerebral artery infarction patients fluid intake effects on malignant brain edema occurred.2.The traditional Chinese medicine on patients with large area cerebral infarction according to the theory of“cerebral water stasis syndrome”treatment for malignant middle cerebral artery blood flow in patients with large area cerebral infarction clinical practicality and feasibility,combining Chinese and western medicine treatment for large area cerebral infarction provide evidence-based study basis.MethodsUsing retrospective study method,this paper analyzed the patients on January 1,2013 to December 31,2017 hospitalized with large area cerebral infarction cases included in the standard in the Guangdong Provincial Hospital of traditional Chinese Medicine.By looking at previous medical records to collect the required medical records:(1)the acute stroke patients with the clinical classification,according to TOAST criteria:large artery atherosclerosis,cardiac embolism,small artery occlusion,the other to determine the reason caused by stroke and stroke with the unclear reason.(2)patients’ demographic characteristics,Glasgow(GCS)score on admission to hospital,systolic blood pressure,blood glucose values,etc.(3)the discrepancy quantity indicators:every 24 h total fluid intake,the total discharge quantity,total amount of urine and net liquid balance,etc.(4)special drug use:every 24 h,mannitol and 10%NaCl,cefuroxime.Sammy,the amount of human serum albumin injection.(5)imaging data:record according to the results of the head CT/MR infarction patients with hemisphere,infarction,diameter,midline structure shift,and so on and so forth.(6)TCM four diagnostic data.Whether hospitalization for malignant brain edema as ending index,according to whether malignant brain edema were divided into malignant brain edema and non malignant brain edema group,respectively in each group have statistically compare various related factors.Application SPSS17.0 statistical software for statistical analysis,preliminary analysis in patients with acute large area cerebral infarction early fluid intake the relationship with the prognosis,and treatment in patients with large area cerebral infarction cerebral water stasis syndrome distribution.Results(1)The subjects included 139 patients,male 69 cases(49.6%),female 70 cases(50.4%).Patients age 38 to 96 years,mean age(72.63-12.46).The 73 cases with malignant brain edema(52.52%),the 66 cases without malignant brain edema(47.48%),the incidence of malignant brain edema was 52.52%.(2)In whether malignant brain edema group,compared with the malignant brain edema group,two groups of patients with infarction diameter,whether with bleeding,whether to bone flap surgery,whether or not to use drugs,using mannitol,using hypertonic salt,the use of albumin,furosemide dehydration were statistically significant(P<0.05).(3)Using the binary classification unconditioned logistic regression analysis of single factor affecting large area cerebral infarction risk factors for malignant brain edema,results suggest infarction in diameter(OR=1.381,95%Cl:1.138,1.676,P=0.001),with bleeding(OR-2.344,95%Cl:1.063,5.167,P=0.035),to bone flap surgery(OR=2.255,95%Cl:1.041,4.885,P=0.039),the use of medications(OR=7.258,95%Cl:2.751,19.152,P<0.001),the use of mannitol dehydrate(OR=3.804,95%Cl:1.882,7.690,P<0.001),the use of albumin dehydration(OR=3.059,95%Cl:1.503,6.225,P<0.001),furosemide dehydration(OR=2.949,95%CI:1.476,5.893,P=0.002)were statistically significant(P<0.05).(4)Using the binary classification unconditioned logistic regression analysis of multiple factors affecting large area cerebral infarction risk factors for malignant brain edema,results suggest infarction diameter(OR-1.744,95%Cl:1.282,2.371,P<0.001),the second day fluid intake(OR=0.532,95%Cl:0.298,0.949,P-0.033)were statistically significant(P<0.05).(5)In this topic,139 cases of patients,in 100 patients with cerebral water and blood stasis syndrome(71.94%),does not conform to the patients with cerebral water stasis 17 cases(12.23%).According to this project data analysis,we found that middle cerebral artery blood supplv zone of large area cerebral infarction patients in line with the proportion of cerebral water stasis license is 71.94%.(6)Of large area cerebral infarction patients with malignant brain edema and non malignant brain edema,cerebral water stasis syndrome distribution difference had no statistical significance(P>0.05),cerebral water stasis and malignant brain edema occurred in patients with large area cerebral infarction had no relevance.(7)In patients with large area cerebral infarction cerebral water stasis grouped according to whether malignant brain edema,compared with non malignant brain edema,malignant brain edema group in infarction diameter,whether with bleeding,whether or not to use drugs,using mannitol,the use of albumin,the use of furosemide dehydration were statistically significant(P<0.05)·(8)Using the binary classification unconditioned logistic regression analysis of single factor affecting large area cerebral infarction cerebral water and blood stasis syndrome in patients with risk factors for malignant brain edema,results suggest infarction diameter(OR=1.462,95%Cl:1.151,1.856,P=0.002).the use of medications(OR=6.896.95%CI:2.315.20.540,P=0.001),the use of mannitol dehydrate(OR=3.713,95%CI:1.620,8.511,P=0.002),the use of albumin dehydration(OR=3.819,95%Cl:1.631,8.943,P=0.002),the use of furosemide dehydration(OR=2.865,95%Cl:1.270,6.467,P=0.011)were statistically significant(P<0.05).(9)Using the binary classification unconditioned logistic regression analysis of multiple factors affect large area cerebral infarction cerebral water and blood stasis syndrome in patients with risk factors for malignant brain edema,results suggest infarction diameter(OR=1.839,95%Cl:1.238,2.733,P=0.003)was statistically significant(P<0.05).Conclusion1.Infarction diameter is large area cerebral infarction patients undergo malignant brain edema and independent factors.2.Malignant brain edema appears during large area cerebral infarction patients in the hospital is no clear relationship to early rehydration,diameter,merging,hemorrhage and infarction,to bone flap surgery,using medications,use of mannitol,the use of albumin,the use of furosemide dehydration.3.The large area cerebral infarction patients in line with the proportion of cerebral water stasis license is 71.94%,and cerebral water stasis distribution has nothing to do with the large area cerebral infarction patients with malignant brain edema occurred.4.Large area cerebral infarction patients with malignant brain edema of cerebral water stasis syndrome is no clear relationship to early rehydration,diameter and infarction,whether or not to use drugs,using mannitol,the use of albumin,the use of furosemide dehydration.