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[摘要]
目的 探讨超早期使用丁苯酞注射液对急性脑梗死患者神经功能及侧支循环建立的影响。方法 选取2014年7月—2017年7月漯河市第二人民医院诊治的急性脑梗死患者86例作为研究对象,按照入院先后顺序分为对照组(42例)和观察组(44例)。对照组给予阿替普酶静脉溶栓治疗,观察组在阿替普酶静脉溶栓前后给予丁苯酞注射液100 mL静脉滴注,2次/d,两次间隔时间为7 h,治疗14 d。比较两组患者治疗前和治疗14 d的临床有效率、侧支循环血流速度,比较两组患者治疗前、治疗1 h、治疗7 d和治疗14 d的美国国立卫生院神经功能缺损评分(NIHSS)和日常生活能力(ADL)评分。结果 观察组的临床有效率为90.91%,对照组的临床有效率为78.57%,观察组显著高于对照组(P<0.05)。两组患者NIHSS评分在治疗1 h、治疗7 d和治疗14 d均显著低于治疗前(P<0.05),且观察组在治疗1 h、治疗7 d和治疗14 d均显著低于对照组(P<0.05)。两组患者ADL评分在治疗1 h、治疗7 d和治疗14 d均显著高于治疗前(P<0.05),且观察组在治疗1h、治疗7 d和治疗14 d均显著高于对照组(P<0.05)。两组患者治疗后大脑中动脉(MCA)流速显著加快,大脑前动脉(ACA)和大脑后动脉(PCA)流速显著减慢(P<0.05);且治疗后观察组MCA流速与对照组相比较快(P<0.05),观察组ACA和PCA流速与对照组相比较慢(P<0.05)。结论 超早期使用丁苯酞注射液治疗急性脑梗死可显著改善患者的神经功能、提高生活能力,改善侧支循环血流速度,取得较好的临床疗效。
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[Abstract]
Objective To explore the influence of ultra-early use of butylphthalide injection on nerve function and collateral circulation in patients with acute cerebral infarction.Methods 86 cases of acute cerebral infarction treated by Luohe second people's hospital from July 2014 to July 2017 were selected and divided into control group (42 cases) and observation group (44 cases) according to the order of admission. The control group was treated with alteplase thrombolytic therapy, the observation group was treated butylphthalide injection on the basis of control group. The clinical efficacy and collateral circulation blood velocity were compared between the two groups before and after treatment. NIHSS and ADL score were compared in 1h after treatment, 7d after treatment and 14 d after treatment between the two groups.Results The clinical efficacy of the observation group was 90.91%, the control group was 78.57%, the observation group was significantly higher than the control group (P<0.05); NIHSS score after treatment 1 h, 7 d and 14 d in both groups were significantly lower than before treatment (P<0.05), and the observation group after treatment 1 h, 7 d and 14 d were significantly lower than control group (P<0.05); ADL scores after treatment 1 h, 7 d and 14 d in both groups were significantly higher than before treatment (P<0.05), and the observation group after treatment 1 h, 7 d and 14 d were significantly higher than control group (P<0.05); MCA flow speed in both group after treatment, ACA and PCA slows down (P<0.05), MCA velocity faster in observation group than the control group after treatment (P<0.05), ACA and PCA velocity slow in observation group compared with the control group (P<0.05). Conclusions The treatment of acute cerebral infarction with butylphthalein injection in the ultra-early can significantly improve the patients' neurological function, improve their living ability, improve the blood flow speed of collateral circulation, and achieve better clinical efficacy.
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