微泵注入普通肝素治疗急性进展性脑梗死的临床研究  

Clinical study on treatment of acute progressive cerebral infarction with unfractionated heparin injected by micro-injection pump

作　　者：张本平[1] 李杰[1] 衣婷婷[1] 

机构地区：[1]哈尔滨医科大学附属第二医院神经内科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2017年第5期438-441,共4页Journal of Harbin Medical University

基　　金：黑龙江省教育厅科学技术研究项目(12541535)

摘　　要：目的探讨普通肝素微泵注入对急性进展性脑梗死患者神经功能缺损程度的改善作用。方法将240例急性进展性脑梗死患者随机分为4组:A组采用普通肝素微量持续静脉泵入;B组采用普通肝素12 500 U每天静脉滴注一次;C组采用低分子肝素5 000 U每天两次皮下注射;D组采用常规治疗。对各组患者神经功能缺损程度、临床疗效、凝血指标和出血事件进行观察和对比。结果治疗7天及14天,A组的神经功能缺损评分显著低于B组、C组和D组(P<0.01);治疗14天,A组总有效率高于B组、C组和D组(P<0.01);治疗7天,APTT值和TT值A组与B组、C组和D组相比明显延长(P<0.01);尽管A组APTT值和TT值延长,A组出血事件发生率虽高于B组、C组和D组,但差异无统计学意义(P>0.05)。结论微泵注射普通肝素能明显改善急性进展性脑梗死神经功能缺损并且安全有效。Objective To investigate the improvement effect of unfractionated heparin injected by micro-injection pump in acute progressive cerebral infarction patients with neurological function deficits. Methods Two hundred and forty cases of acute progressive cerebral infarction patients were randomly divided into four groups： group A were treated with continuous venous transfusion of unfractionated heparin which Was controlled by micro-injection pump; group B were treated with unfractionated heparin 12 500 U intravenous infusion once a day; group C were treated with low molecular weight heparin 5 000 U subcutaneous injection twice a day; group D were treated with conventional therapy. The degree of neurological function deficits, coagulation indexes, clinical effect and bleeding events of the patients in each group were ob- served and compared. Results The scores of neurological function deficits in group A was lower than that in group B, group C and group D after 7 days and 14 days treatment （ P 〈 0.01 ） ; Total efficiency in group A was higher than that in group B, group C and group D after 14 days treatment （P 〈 0. 01 ） ; APTT and Tin in group A was longer than that in group B,group C and group D after 7 days treatment （ P 〈 0. 01 ） ; Although AlYYF and TF in group A was longer than other groups and bleeding event rate in group A was higher than that in group B, group C and group D, the bleeding event rate in the four groups showed no significant difference （P 〉 0. 05 ）. Conclusion Injection of unfractionated heparin by micro-injection pump is safe and can improve neurological function of patients with acute progressive cerebral infarction.

关 键 词：普通肝素 微泵 进展性脑梗死 神经功能缺损 

分 类 号：R743.33[医药卫生—神经病学与精神病学]