本文選題：低分子右旋糖酐 + 顱內(nèi)血管支架成形術(shù)　； 參考：《廣東醫(yī)學(xué)》2017年08期

【摘要】：目的探討術(shù)前應(yīng)用低分子右旋糖酐對(duì)顱內(nèi)血管支架成形術(shù)治療老年缺血性腦血管病變患者凝血功能和炎性因子的影響。方法選取60例存在顱內(nèi)血管狹窄的老年缺血性腦血管病變患者作為研究對(duì)象,回顧性分析患者臨床資料,按照治療方案分為對(duì)照組28例和觀察組32例。所有患者均行顱內(nèi)血管支架成形術(shù)治療。對(duì)照組患者給予常規(guī)治療,觀察組在對(duì)照組基礎(chǔ)上給予低分子右旋糖酐治療。比較兩組患者手術(shù)情況,術(shù)后再狹窄發(fā)生率、手術(shù)前后Alberta卒中項(xiàng)目早期CT評(píng)分(ASPECTS)、凝血功能指標(biāo)及炎性因子水平。結(jié)果所有患者顱內(nèi)血管支架成形術(shù)均成功,手術(shù)成功率100%。觀察組并發(fā)癥發(fā)生率低于對(duì)照組(6.2%vs 32.1%,P0.05)。隨訪1年,觀察組和對(duì)照組患者術(shù)后再狹窄發(fā)生率組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(3.1%vs 14.3%,P0.05)。術(shù)后72h,觀察組ASPECTS評(píng)分高于對(duì)照組(P0.05)。術(shù)后72 h,與對(duì)照組比較,觀察組凝血酶原時(shí)間、活化部分凝血酶時(shí)間、凝血酶時(shí)間延長(zhǎng),纖維蛋白原水平降低,白細(xì)胞介素(IL)-6、IL-8、腫瘤壞死因子-α等炎性因子水平降低,組間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論術(shù)前給予低分子右旋糖酐在顱內(nèi)血管支架成形術(shù)治療老年缺血性腦血管病變中應(yīng)用效果良好,能夠減少術(shù)后并發(fā)癥發(fā)生率,增加術(shù)后腦血流灌注,并且能夠改善凝血功能,減輕炎性反應(yīng),臨床上值得應(yīng)用。
[Abstract]:Objective to investigate the effect of low molecular weight dextran on coagulation function and inflammatory factors in elderly patients with ischemic cerebrovascular disease. Methods 60 elderly patients with ischemic cerebrovascular disease with intracranial vascular stenosis were selected as subjects. The clinical data were retrospectively analyzed and divided into control group (n = 28) and observation group (n = 32). All patients were treated with intracranial stent angioplasty. The patients in the control group were treated with routine therapy, and the patients in the observation group were treated with low molecular weight dextran on the basis of the control group. The postoperative restenosis rate, early CT score of Alberta stroke project, coagulation function index and inflammatory factor level were compared between the two groups. Results Intracranial angioplasty was successful in all patients, and the success rate was 100%. The incidence of complications in the observation group was lower than that in the control group (6.2 vs 32.1). There was no significant difference in the incidence of restenosis between the observation group and the control group after 1 year follow-up. There was no significant difference in the incidence of restenosis between the observation group and the control group (3.1 vs 14.3P0.05). At 72 hours after operation, the ASPECTS score in the observation group was higher than that in the control group (P 0.05). At 72 hours after operation, the prothrombin time, activated partial thrombin time, fibrinogen level, IL-8, tumor necrosis factor- 偽 and other inflammatory factors were decreased in the observation group compared with those in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion preoperative application of low-molecular-weight dextran in the treatment of senile ischemic cerebrovascular disease is effective, which can reduce the incidence of postoperative complications, increase cerebral blood perfusion, and improve coagulation function. It is worthy of clinical application to alleviate inflammatory reaction.
【作者單位】： 西安交通大學(xué)醫(yī)學(xué)院附屬漢中三二○一醫(yī)院神經(jīng)外科;延安大學(xué)醫(yī)學(xué)院生物化學(xué)與分子生物學(xué)教研室;
【分類號(hào)】：R651.12

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