长时程连续心电监控房颤对预防缺血性卒中后复发临床研究.docVIP

长时程连续心电监控房颤对预防缺血性卒中后复发临床研究 　　【摘要】 目的：研究长时程连续心电监控房颤对急性缺血性卒中（发病5 d）入住院患者的卒中后复发情况。方法：将筛选的103例急性缺血性脑卒中且STAF评分5分的患者，按是否进行10 d长时程或者短时程2个24 h动态心电监测房颤是否发生，分成监控组51例和常规组52例，比较两组患者的房颤检出率、脑卒中复发卒中复发率，并按照美国国立卫生研究院健康卒中评分标准计算NIHSS分值、平均住院天数。结果：监控组中共检诊断阵发性心房颤动患者9例（17.6%），常规组中诊断出阵发性心房颤动患者3例（5.8%），监控组阵发性房颤的检出率明显高于常规组（P0.05）。监控组脑卒中复发3例（5.9%）明显低于常规组7例（13.5%）；监控组脑卒中后NIHSS评分（9.7±4.1）分低于常?组（18.3±5.4）分；监控组脑卒中后平均住院日（15.9±5.1）d低于常规组（23.1±11.3）d，各指标间比较均有统计学意义（P0.05）。结论：长时程连续心电监控房颤可以及早发现并纠正房颤，降低脑卒中复发率，降低脑卒中复发后的NIHSS评分，减少平均住院日。 　　【关键词】 房颤； 脑卒中； 动态心电图； 复发率 　　【Abstract】 Objective：To investigate the post-stroke relapse of inpatients with acute ischemic stroke by the long-term continuous electrocardiogram monitoring of recurrent atrial fibrillation （disease time less than 5 days）.Method：103 selected stroke patients with STAF score of 5 were divided into monitoring group of 51 cases and common group of 52 cases according to whether or not receive 10-day long-term ECG monitoring or 2 times of 24-hour dynamic ECG monitoring to determine whether atrial fibrillation was occurred.The detection rate of atrial fibrillation and the recurrent rate of recurrent stroke， as well as the NIHSS score and the average duration of hospitalization of patients in the two groups were compared.Result：There were 9 patients（17.6%）diagnosed with paroxysmal atrial fibrillation in the monitoring group，while there were 3 patients（5.8%）diagnosed with paroxysmal atrial fibrillation in the common group，the detection rate of paroxysmal atrial fibrillation in the monitoring group was obviously higher than that in the common group（P0.05）.The recurrent rate of stroke in the monitoring was 5.9% evidently lower than that in the common group 13.5%（P0.05）.The post-stroke NIHSS score of the monitoring group was （9.7±4.1）points lower than that of the common group（18.3±5.4）points（P0.05）.The average duration of hospitalization after stroke of the monitoring group was （15.9±5.1）d less than that of the common group（23.1±11.3）d（P0.05）.Conclus