急性脑梗死发病后6~12h 应用小剂量尿激酶、低分子肝素和奥扎格雷钠联合治疗的临床效果研究

摘要

目的：探讨急性脑梗死发病后6~12 h 应用小剂量尿激酶、低分子肝素和奥扎格雷钠联合治疗的临床效果。方法选取2013年1月—2015年6月佛山市南海区第二人民医院神经内科收治的发病至入院时间为6~12 h 的急性脑梗死患者83例，按治疗方法不同分为 A 组35例与 B 组48例。A 组患者予以常规方法治疗，B 组患者予以小剂量尿激酶、低分子肝素和奥扎格雷钠联合治疗；两组患者均连续治疗14 d。比较两组患者治疗前及治疗24 h、7 d、14 d 美国国立卫生研究院卒中量表（NIHSS）评分，治疗前、治疗后14 d 神经功能缺损量表（NDS）评分、Barthel 指数，不良反应发生情况。结果治疗前两组患者 NIHSS 评分比较，差异无统计学意义（P ﹥0.05）；治疗24 h、7 d、14 d B组患者 NIHSS 评分低于 A 组（P ﹤0.05）。治疗前两组患者 NDS 评分、Barthel 指数比较，差异无统计学意义（ P ﹥0.05）；治疗14 d B 组患者 NDS 评分低于对照组，Barthel 指数高于对照组（P ﹤0.05）。两组患者不良反应发生率比较，差异无统计学意义（P ﹥0.05）。结论急性脑梗死发病后6~12 h 应用小剂量尿激酶、低分子肝素和奥扎格雷钠联合治疗的临床效果确切，可有效改善患者神经功能，提高患者生活质量，且安全性较高。%Objective To explore the clinical effect of low - dose urokinase,low molecular heparin combined with sodium ozagrel applied after 6 to 12 hours of onset of acute cerebral infarction. Methods From January 2013 to June 2015,a total of 86 patients with acute cerebral infarction(duration between onset and admission within 6 to 12 hours)were selected in the Department of Neurology,the Second People's Hospital of Nanhai District,Foshan,and they were divided into A group(n= 35)and B group(n = 48)according to the therapeutic methods. Patients of A group received conventional treatment,while patients of B group received low - dose urokinase, low molecular heparin combined with sodium ozagrel; both groups continuously treated for 14 days. NIHSS score before treatment,after 24 hours,7 days and 14 days of treatment,NDS score and Barthel index before treatment and after 14 days of treatment,and incidence of adverse reactions were compared between the two groups. Results No statistically significant differences of NIHSS score was found between the two groups before treatment (P ﹥ 0. 05);after 24 hours,7 days and 14 days of treatment,NIHSS score of B group was statistically significantly lower than that of A group,respectively( P ﹤ 0. 05). No statistically significant differences of NDS score or Barthel index was found between the two groups before treatment( P ﹥ 0. 05);after 14 days of treatment,NDS score of B group was statistically significantly lower than that of control group,while Barthel index was statistically significantly higher than that of control group (P ﹤ 0. 05). No statistically significant differences of incidence of adverse reactions was found between the two groups( P ﹥0. 05). Conclusion The clinical effect of low - dose urokinase,low molecular heparin combined with sodium ozagrel applied after 6 to 12 hours of onset of acute cerebral infarction is certain,can effectively improve the neurological function and quality of life,with relatively high safety.