摘要
目的探索替罗非班对心源性脑栓塞患者血管再通手术效果的影响。方法选择2020年8月至2021年11月河南省第二人民医院收治的23例急性心源性脑栓塞患者、郑州大学第一附属医院收治的47例急性心源性脑栓塞患者、郑州市第一人民医院收治的54例急性心源性脑栓塞患者为研究对象,采用随机数字表法将患者分为对照组(n=62)和观察组(n=62)。对照组患者实施血管再通术动脉灌注治疗;观察组患者在对照组治疗的基础上给予替罗非班动脉灌注,并于术后微量泵入替罗非班,直至患者病情初步稳定。治疗1周后,使用美国国立卫生院卒中量表(NIHSS)评估患者的运动、视野、眼球运动、语言、意识、共济运动以及感觉等神经功能缺损状况,并评定临床疗效;观察2组患者颅内出血、高灌注脑病、脑疝及短暂性脑部缺血发作等并发症发生情况。结果治疗1周后,观察组患者的运动、视野、眼球运动、语言、意识、共济运动及感觉评分显著低于对照组(P<0.05)。对照组患者显效27例(43.55%),有效22例(35.48%),无效13例(20.97%),总有效率为79.03%(49/62);观察组患者显效34例(54.84%),有效26例(41.93%),无效2例(3.23%),总有效率为96.77%(60/62);观察组患者的总有效率显著高于对照组(χ^(2)=8.326,P<0.05)。治疗1周后,对照组患者发生高灌注脑病2例(3.23%)、颅内出血3例(4.84%)、短暂性脑部缺血发作1例(1.61%)、脑疝2例(3.23%),并发症发生率为12.90%(8/62);观察组患者发生颅内出血1例(1.61%),脑疝1例(1.61%),并发症发生率为3.23%(2/62);观察组患者的并发症发生率显著低于对照组(χ^(2)=7.652,P<0.05)。结论血管再通手术中添加替罗非班进行治疗,能够有效减轻急性心源性脑栓塞患者的神经功能受损程度,降低并发症的发生风险。
Objective To explore the effect of tirofiban on the outcome of revascularization operation in patients with cardiogenic cerebral embolism.Methods Twenty-three patients with acute cardiogenic cerebral embolism admitted to the Second People′s Hospital of Henan Province,47 patients with acute cardiogenic cerebral embolism admitted to the First Affiliated Hospital of Zhengzhou University,54 patients with acute cardiogenic cerebral embolism admitted to the First People′s Hospital of Zhengzhou from August 2020 to November 2021 were selected as the research objects.The patients were divided into the control group(n=62)and the observation group(n=62)by random number table method.The patients in the control group were treated with arterial infusion of vascular recanalization,and the patients in the observation group were treated with arterial infusion of tirofiban based on the treatment of the control group,and tirofiban was injected into the micro-pump after the operation until the patient′s condition was initially stable.After one week of treatment,the neurological deficits such as movement,visual field,eye movement,language,consciousness,ataxia and sensation of patients were evaluated by the National Institutes of Health Stroke Scale(NIHSS);and the clinical efficacy was evaluated at the same time.The occurrence of complications such as intracranial hemorrhage,hyperperfusion encephalopathy,cerebral herniation and transient ischemic attack of patients in the two groups were observed.Results After one week of treatment,the scores of movement,visual field,eye movement,language,consciousness,ataxia and sensation of patients in the observation group were significantly lower than those in the control group(P<0.05).In the control group,27 cases(43.55%)were markedly effective,22 cases(35.48%)were effective,and 13 cases(20.97%)were ineffective,and the total effective rate was 79.03%(49/62);in the observation group,34 cases(54.84%)were markedly effective,26 cases(41.93%)were effective,2 cases(3.23%)were ineffective,and the
作者
孟庆军
王朝刚
水少锋
MENG Qingjun;WANG Chaogang;SHUI Shaofeng(Department of Neurointervention,the Second People′s Hospital of Henan Province,Xinzheng 451191,Henan Province,China;Department of Neurointervention,the First People′s Hospital of Zhengzhou,Zhengzhou 450006,Henan Province,China;Department of Neurointervention,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450056,Henan Province,China)
出处
《新乡医学院学报》
CAS
2023年第4期357-360,共4页
Journal of Xinxiang Medical University
关键词
替罗非班
心源性脑栓塞
血管再通
手术疗效
tirofiban
cardiogenic cerebral embolism
recanalization
surgical efficacy
