非瓣膜性心房颤动脑栓塞早期抗凝的安全性与获益  

The Safety and Benefit of Non Valvular Atrial Fibrillation Cerebral Embolism Early Anticoagulation

作　　者：黄国敏[1] 黄丹丹[1] 邓耀芳[1] 黄汉宁[1] 

机构地区：[1]广东省高州市人民医院,广东高州525200

出　　处：《中国医学创新》2016年第13期32-35,共4页Medical Innovation of China

基　　金：茂名市科技计划项目(20140330)

摘　　要：目的:探讨非瓣膜性心房颤动脑栓塞患者早期应用华法林抗凝的治疗效果及安全性。方法:选取2014年4月-2015年6月本院收治的非瓣膜性心房颤动脑栓塞急性期患者100例作为研究对象,根据抗凝应用时间的不同分为对照组和观察组,每组50例。对照组于起病后2周应用华法林抗凝,观察组起病后立即应用华法林抗凝,比较两组的出血转化率、卒中复发率、并发症发生情况、治疗前后神经功能缺损NIHSS评分情况、改良m RS评分情况及6个月随访生存率。结果:治疗后,两组NIHSS和m RS评分均较治疗前降低,且观察组优于对照组,比较差异均有统计学意义(P<0.05);观察组卒中复发率为6.0%,脑栓塞复发率为4.0%,并发症发生率为16.0%,分别低于对照组的18.0%、14.0%和34.0%,两组比较差异均有统计学意义(P<0.05);观察组随访3个月的生存率为98.0%,高于对照组的84.0%,两组比较差异有统计学意义(P<0.05)。结论:非瓣膜性心房颤动脑栓塞患者早期应用华法林抗凝治疗的临床效果较好,安全性高,并发症少,在降低出血风险的同时又可降低复发卒中的风险,对降低残疾率及提高患者生活质量具有重要意义,值得临床推广。Objective：To investigate the curative effect and safety of non valvular atrial fibrillation cerebral embolism in patients with early application of Warfarin.Method：From April 2014 to June 2015,100 cases of non valvular atrial fibrillation cerebral embolism acute period in our hospital were selected as the research objects,they were divided into control group and observation group according to the different time of anticoagulation,each group had 50 cases.The control group was used Warfarin 2 weeks after onset and observation group was immediately used Warfarin after onset.The bleeding conversion rate,stroke recurrence rate,the incidence of complications,before and after treatment of neurological functional defect NIHSS score,modified m RS score and 6 months follow-up survival rate of two groups were compared.Result：After treatment,NIHSS and m RS scores of two groups were lower than before treatment,and the observation group of that was better than control group,the differences were statistically significant（P〈0.05）.The recurrence rate of stroke,cerebral embolism and the complication rate of observation group were respectively 6.0%,4.0% and 16.0%,which lower than the control group of 18.0%,14.0% and 34.0%,the differences were statistically significant（P〈0.05）.After 3 months,the survival rate of observation group was 98.0%,higher than the control group of 84.0%,the difference was statistically significant（P〈0.05）.Conclusion：Non valvular atrial fibrillation brain embolism treat with Warfarin has a good clinical effect,not only has high safety and less complications,but also can reduce the risk of bleeding and recurrent stroke,it has important significance to reduce the disability rate and improve the quality of life in patients,it is worthy of clinical promotion.

关 键 词：非瓣膜性心房颤动脑栓塞 华法林 可行性 

分 类 号：R541.75[医药卫生—心血管疾病]