肝素联合抗血小板疗法对心源性脑栓塞的应用效果  

Effect of heparin combined with antiplatelet therapy on cardiogenic cerebral embolism

作　　者：牟晓莉[1] 王文凯[1] 蔡莱新 MOU Xiao-li;WANG Wen-kai;CAI Lai-xin(Department of Neurology,Second People's Hospital of Hainan Province,Wuzhishan 572299,Hainan,China)

机构地区：[1]海南省第二人民医院神经内科

出　　处：《川北医学院学报》2019年第4期370-372,共3页Journal of North Sichuan Medical College

基　　金：海南省卫计委项目(15A200047)

摘　　要：目的:探讨运用肝素联合抗血小板疗法对心源性脑栓塞(cardiogenic cerebral embolism,CCE)的临床效果。方法:将84例CCE患者随机数表法分为对照组和实验组,每组各42例。对照组给予常规抗血小板治疗,实验组给予肝素联合抗血小板治疗。比较两组患者治疗前后神经功能缺损评分(NIHSS、NFDS量表)、日常生活自理能力(ADL)及临床疗效、不良反应情况等。结果:治疗后,两组患者NIHSS、NFDS评分均较治疗前显著下降( P<0.05),且实验组较对照组下降更为显著,差异有统计学意义(P <0.05)。实验组治疗后ADL评分优于对照组,差异有统计学意义( Z=-3.037,P <0.05);实验组治疗总有效率为90.48%,高于对照组的73.81%,差异有统计学意义(χ 2 =3.977, P <0.05);实验组、对照组不良反应率分别为11.90%、16.67%,二者比较差异无统计学意义(χ 2 =0.389, P >0.05)。结论:肝素联合抗血小板治疗能有效改善CCE患者神经功能和生活自理能力,增强临床疗效,是一种安全有效的治疗方案,值得临床推广运用。Objective: To investigate the clinical effect of heparin combined with antiplatelet therapy in the treatment of cardiogenic cerebral embolism(CCE). Methods: 84 patients with CCE were randomly divided into control group and experimental group,each group had 42 cases.The control group was given conventional antiplatelet therapy,while the experimental group was given heparin combined with antiplatelet therapy.The neurological deficit scores(NIHSS,NFDS),ability of daily life(ADL),clinical efficacy and adverse reactions were compared between the two groups before and after treatment. Results: After treatment,the scores of NIHSS and NFDS in the two groups were significantly lower than those before treatment( P <0.05),and the decrease in the experimental group was more significant than that in the control group( P <0.05).The ADL score of the experimental group was better than that of the control group( Z =-3.037, P <0.05),the total effective rate of the experimental group was 90.48%,which was than 73.81% of the control group(χ 2 = 3.977, P <0.05),the adverse reactions of the experimental group and the control group were 11.90% and 16.67%,respectively,with no significant difference(χ 2=0.389, P >0.05). Conclusion: Heparin combined with antiplatelet therapy can effectively improve the neurological function and self-care ability of CCE patients,and enhance the clinical efficacy.It is a safe and effective treatment program,which is worthy of clinical application.

关 键 词：心源性脑栓塞 肝素 抗血小板 神经功能 日常生活自理能力 疗效 

分 类 号：R743.33[医药卫生—神经病学与精神病学]