低分子肝素钙联合依达拉奉治疗进展性脑梗死疗效分析.docVIP

低分子肝素钙联合依达拉奉治疗进展性脑梗死疗效分析 　　[摘要] 目的 探讨低分子肝素钙联合依达拉奉治疗进展性脑梗死临床效果。方法 我院2008年3月~2009年10月收治进展性脑梗死患者49例,随机分为对照组和治疗组。对照组给予常规治疗,治疗组在常规治疗基础上给予低分子肝素钙和依达拉奉。结果 两组患者治疗后神经功能缺损评分均低于治疗前,治疗后治疗组功能缺损评分显著低于对照组;对照组总有效率80.0%,治疗组总有效率93.1%,两组总有效率比较差异有显著性。结论 低分子肝素钙与依达拉奉联用有效改善进展性脑梗死预后,值得临床推广。 　　[关键词] 低分子肝素钙;依达拉奉;进展性;脑梗死 　　[中图分类号] R743.3 [文献标识码] A[文章编号] 1673-9701(2010)12-150-02 　　 　　Curative Effect of Low Molecular Heparin Calcium Combined with Edaravone for Progressive Cerebral Infarction 　　YANG YushengCHEN XindongCHEN Yonghui 　　Department of Medicine,Lufeng City Peoples Hospital in Guangdong Province,Lufeng 516500,China 　　 　　[Abstract] Objective To discuss the curative effect of low molecular heparin calcium combined with edarvone for progressive cerebral infarction. Methods We selected 49 of patients with cases of progressive cerebral infarction and divided them into treatment group and control group. Both groups received conventional therapy,and low molecular heparin calcium combined with edaravone was added to the treatment group. Results The neurological deficit score of the two groups was lower than that before treatment,and the score was significantly lower in the treatment group than that of the control group. The total effective rate was 80.00% in the control group and 93.1% in the treatment group. Conclusion Low molecular heparin calcium in conjunction with the use of edaravone can effectively improve prognosis of progressive cerebral infarction,worthy to be popularized. 　　[Key words] Low molecular heparin calcium;Edarvone;Progressive;Cerebral infarction 　　进展性脑梗死是脑梗死发生后神经功能缺失症状较轻微,但发病6h后,缺血症状进展或组织坏死进一步加重,出现较严重的神经功能恶化。病死率和致死率高于一般脑卒中,占一般脑卒中的26%~43%[1]。发病原因是颅内动脉或颅外动脉供应脑部血液时发生闭塞性病变,侧支循环未能及时形成,造成局部脑组织血供不及??,代谢受阻,进而脑组织缺血坏死,缺血坏死区进展性扩大,神经功能恶化。脑缺血达一定程度时,再灌注以期恢复缺血区血供也会加重脑缺血性损害。导致进展性的原因为脑部和全身因素。脑部因素包括脑水肿、再灌注损伤;全身性因素包括高血压、低血压、高血糖、低血糖、血液黏稠度升高、缺氧、脱水等[2]。临床治疗早期急性脑梗死使用尿激酶进行溶栓治疗,效果已经得到认可,但是对于超过6h后,病灶仍然继续发展的进展性脑梗死治疗效果不佳,难于控制。我院2008年3月~2009年10月收治进展性脑梗死患者49例,采用低分子肝素钙和依达拉奉联合治疗,效果良好,现报道如下。