Analysis of prognosis of infarction in different areas of medulla oblongata

Objective To study the clinical characteristics and prognostic factors of different areas of medulla oblongata infarction. Methods From April 2019 to November 2019,63 patients with acute medullary infarction in the Department of Neurology,the First Affiliated Hospital of Harbin Medical University were selected as the research objects. The clinical information of the patients was collected,including general information,clinical symptoms and signs,complications,imaging characteristics. NIHSS score was used to evaluate the severity of the disease,and mRS score was used to evaluate the prognosis. Results( 1) The incidence rate of male patients with medullary infarction was higher than that of females. The most common sites of medullary infarction were lateral,head and left. The lateral infarction of medulla oblongata is more common in the middle of medulla oblongata,while the medial infarction is more common in the head of medulla oblongata. The peak age was 61 ～ 70 years old. Among them,the incidence rate of male at 51 ～ 60 is higher than that of female,and the incidence rate of female is higher than that of male at 61 ～ 70 years old.( 2) In a single factor analysis,dysphagia and abnormal pharyngeal reflex were higher than the poor prognosis group in the 30-day good prognosis group,dizziness or dizziness,nausea and vomiting in the 90-day good prognosis group were higher than the poor-prognosis group,and quadriplegia in the 90-day poor prognosis group was higher than the good prognosis group,and the differences between the groups are statistically significant. In lateral infarction,the good prognosis group was higher than the poor prognosis group at 90 days,and the difference between the groups was statistically significant. The dyspnea in the 90-day poor prognosis group was higher than that in the good prognosis group,and the difference between the groups was statistically significant. Progressive stroke in the 30-day and 90-day poor prognosis group was higher than the good prognosis group,the difference between the groups was statistically significant.( 3) In multivariate logistic regression analysis,dysphagia is negatively correlated with a 30-day poor prognosis,and lateral infarction,nausea,and vomiting are negatively correlated with a 90-day poor prognosis. Central facial paralysis is an independent risk factor for a poor prognosis at 30 days. Progressive stroke is an independent risk factor for a poor prognosis at 30 and 90 days. Conclusion( 1) The incidence of medullary infarction is higher in men than women,and the peak age of women is higher than men.( 2) The incidence of medullary cephalic infarction is higher than that of the middle and tail,and the incidence of lateral infarction is higher than that of medial infarction. Lateral medullary infarction has a better prognosis than other regions.( 3) Central facial paralysis is an independent risk factor for poor prognosis of medullary infarction within 30 days. Progressive stroke is an independent risk factor for poor prognosis of bulbar infarction.