摘要
目的:探讨低分子肝素(LMWH)联合华法令早期抗凝治疗急性颅内静脉窦血栓(CVST)的效果。方法:回顾性分析90例接受治疗的急性CVST患者的临床资料,根据其治疗方式分为华法令治疗组和LMWH联合华法令治疗组,疗程1个月。观察2组患者的疗效,比较2组患者治疗前、后凝血指标、神经功能缺损评分、生活质量和脑出血发生率的差异。结果:联合治疗组患者治疗的有效率明显高于华法令组(93.75%vs 78.57%,P<0.05);治疗前2组患者PT、APTT、TT等凝血功能指标无明显差别,治疗后2组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)水平较手术前升高,血浆纤维蛋白原(Fbg)较手术前降低,且联合治疗组变化更明显;2组患者治疗前的美国国立卫生研究院卒中量表(NIHSS)评分无明显差别,治疗后2组患者的NIHSS评分均较治疗前降低,且联合治疗组降低更明显;联合治疗组脑出血发生率明显低于华法令组(P<0.05);2组患者治疗前生活质量得分无明显差别,治疗后2组患者除语言、社会角色、视力和工作/劳动外,其余各维度得分有所上升,且联合治疗组变化更明显。结论:LMWH联合华法令早期抗凝对急性CVST有较好的治疗效果,可明显提高患者的生活质量。
Objective： To investigate the effect of low molecular weight heparin（ LMWH） combined with early warfarin anticoagulation for acute cerebral venous sinus thrombosis（ CVST）. Methods： A retrospective study was performed to analyze the clinical data of 90 patients with CVST. According to the treatment methods,the patients were divided into warfarin group and LMWH combined with warfarin treatment group. The therapeutic effectiveness of two groups was observed,and the blood coagulation index,nerve function defect score,quality of life and the incidence of cerebral hemorrhage of the two groups were compared before and after treatment. Results： The effective rate of combined treatment group was significant higher than that of warfarin group（ 93. 75% vs 78. 57%,P〈0. 05）. Before treatment,prothrombin time（ PT）,activated partial thromboplastin time（ APTT）,thrombin time（ TT） and other blood coagulation function indexes had no significant difference. After treatment,TT,APTT and PT levels in the two groups were higher,and plasma fibrinogen（ Fbg） was lower than before operation,and the changes of combined treatment group were more obvious. Before treatment,the NIHSS score between the two groups had no significant difference. After treatment,the NIHSS scores in the two groups were lower than those before treatment,and decreased more significantly in the combined treatment group. The brain hemorrhage incidence in the combined treatment group was significantly lower than that in the warfarin group（ P〈0. 05）. The quality of life scores before treatment had no significant difference between the two groups. After treatment,except the scores of language,social role,vision and work / labor in four dimensions,the score of rest of each dimension in the two groups all increased. And the changes in the combined treatment group were more obvious. Conclusion： LMWH combined with early warfarin anticoagulation for acute CVST has good treatment effect,which can significantly improve the quality of lif
出处
《内科急危重症杂志》
2016年第6期446-448,共3页
Journal of Critical Care In Internal Medicine
关键词
低分子肝素钙
华法令
抗凝
颅内静脉窦血栓
Low molecular weight heparin calcium
Warfarin
Anticoagulation
Cerebral venous sinus thrombosis
