肝素微量泵应用后在不同时间联合低分子肝素钙治疗急性脑梗死的对比研究

摘要

Objective To investigate the effect of molecular weight heparin calcium following micro-pumped heparin on acute cerebral infarction. Methods Totally 102 cases of acute cerebral infarction were random-ly divided into two groups treated with heparin for 72 hours. Group A had low molecular weight heparin for 6 hours and group B had low molecular weight heparin for 12 hours afterwards. Results Compared with B group, neurologi-cal deficits and activities of daily living of A group were significantly increased, but the bleeding rate did not in-crease. Conclusion Application of low molecular weight heparin calcium therapy 6 hours after stopping heparin is safe and effective for treaing acute cerebral infarction.%目的 探讨肝素微量泵停用后何时联合低分子肝素治疗急性脑梗死既有效又安全.方法 急性脑梗死患者102例,完全随机原则分为A、B 2组各51例,均持续泵入普通肝素72 h.A组于停泵6 h后、B组于12 h后分别给予低分子肝素钙应用.2组于治疗前、治疗后3、10、21 d,分别进行神经功能缺损程度(NIHSS)和日常生活活动能力(MBI)评定并进行比较;比较2组不良终点事件发生率.结果 A组和B组比较,神经功能缺损和生活自理能力恢复程度均有提高,尤其是治疗后10 d(NIHSS:10.85±2.02 vs 6.13±1.68;MBI:64.17±5.63 vs 76.28±6.52;P<0.05),治疗后21 d(NIHSS:9.76±1.98 vs 5.35±1.54;MBI:70.67±6.78 vs 85.59±4.24;P<0.05)而出血率并未增加.结论 停用肝素6 h,可及时加用低钙后续治疗,达到安全性和有效性的最佳时点.