摘要
目的研究阿替普酶静脉溶栓联合甘露醇及低分子量肝素钠治疗脑栓塞患者的疗效。方法选取我院收治的风心病左心房内血栓脱落致脑栓塞患者68例作为研究对象,随机分为两组,对照组33例接受甘露醇及低分子量肝素钠治疗,观察组35例接受阿替普酶静脉溶栓联合甘露醇及低分子量肝素钠治疗,对比两组临床疗效以及治疗前后血液流变学指标[全血低切黏度(WBLSV)、血浆黏度(PV)、全血高切黏度(HBV)]、美国国立卫生院卒中量表(NIHSS)评分、凝血功能指标[D-二聚体(DD)、纤维蛋白原(FIB)、凝血活酶时间(APTT)、凝血酶原时间(PT)]。结果观察组总有效率显著高于对照组(P<0.05);治疗后两组NIHSS评分低于治疗前,观察组低于对照组(P<0.05);治疗后观察组PV、HBV、WBLSV低于对照组(P<0.05);治疗后观察组D-D、FIB低于对照组,APTT短于对照组,PT长于对照组(P<0.05)。结论阿替普酶静脉溶栓联合甘露醇及低分子量肝素钠治疗风心病左心房内血栓脱落致脑栓塞效果显著,可有效改善脑神经缺损,调节凝血功能与血液流变学指标。
Objective To explore the clinical effect of alteplase intravenous thrombolysis combined with mannitol and low molecular weight heparin sodium in the treatment of cerebral embolism.Methods 68 patients with cerebral embo⁃lism caused by detached thrombus in the left atrium of rheumatic heart disease were selected.33 patients in the control group accepted mannitol and low molecular weight heparin therapy and 35 patients in the observation group added alteplase intrave⁃nous thrombolysis on the basis of the control group.The clinical effect,blood rheology indexes before and after treatment[whole blood low shear viscosity(WBLSV),plasma viscosity(PV),whole blood high shear viscosity(HBV)],the US nation⁃al institutes of health stroke scale(NIHSS)scores,blood coagulation function indexs[D-dimer(D-D),fibrinogen(FIB),clot⁃ting enzyme time(APTT),prothrombin time(PT)]of the two groups were compared.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the NIHSS scores of the two groups were lower than those before treatment,and that in the observation group was lower than that in the control group(P<0.05).After treatment,PV,HBV and WBLSV in the observation group were lower than those in the control group(P<0.05);D-D and FIB in the observation group were less than those in the control group;APTT was shorter than that in the control group;PT was longer than that in the control group(P<0.05).Conclusion Alteplase intravenous thrombolysis combined with man⁃nitol and low molecular weight heparin sodium is effective in the treatment of cerebral embolism caused by detached throm⁃bus in the left atrium of rheumatic heart disease,which can effectively improve cerebral nerve defect,regulate blood coagula⁃tion function and hemorheology.
作者
代存芳
DAI Cunfang(Henan(Zhengzhou)Chinese Medicine Department of Modern Medicine Institute,Zhengzhou 450000,Henan)
出处
《菏泽医学专科学校学报》
2020年第4期34-36,72,共4页
Journal of Heze Medical College
关键词
阿替普酶静脉溶栓
甘露醇
低分子量肝素钠
风心病
脑栓塞
Intravenous thrombolysis of alteplase
Mannitol
Low molecular weight heparin sodium
Rheumatic heart disease
Cerebral embolism
