疏血通联合丁苯酞治疗老年急性大面积脑梗死的临床观察

Clinical Observation of Shuxuetong Combined with Butylphthalide in the Treatment of Acute Massive Cerebral Infarction in Elderly Patients

目的:观察疏血通联合丁苯酞治疗老年急性大面积脑梗死的疗效及安全性。方法:选取老年急性大面积脑梗死患者76例,按随机数字表法分为观察组和对照组,各38例。对照组患者采用丁苯酞100 ml,bid;观察组患者在对照组基础上加用疏血通注射液6 ml加入5%葡萄糖注射液200 ml,ivgtt,qd。观察两组患者治疗前后神经功能缺损程度评分、凝血指标、红细胞比积、血小板聚集率变化及临床疗效。结果:治疗后14 d,观察组患者的功能缺损评分[(3.57±0.25)分]明显低于对照组[(5.98±1.13)分],差异有统计学意义(P<0.05);治疗后,观察组患者总有效率(81.58%)显著高于对照组(57.89%),差异有统计学意义(P<0.05);观察组患者血小板聚集率[(52.38±3.74)%]、红细胞比积[(36.21±3.26)%]均显著低于对照组,差异有统计学意义(P<0.05)。治疗前后,两组患者的凝血指标均无明显变化,差异无统计学意义(P>0.05);两组患者均未见明显不良发应发生。结论:疏血通联合丁苯酞治疗老年急性大面积脑梗死疗效较好,对患者神经功能恢复有着积极的影响,且安全性高。

OBJECTIVE： To observe therapeutic efficacy and safety of shuxuetong combined with butylphthalide in the treat- ment of elderly acute massive cerebral infarction. METHODS： 76 elderly patients with acute massive cerebral infarction selected were randomly divided into observation group and control group, with 38 cases in each group. Control group was treated with bu- tylphthalide, 100 ml, bid; observation group was additionally given shuxuetong 6 ml added into 55 Glucose injection 200 ml, ivgtt, qd, on the basis of control group. The NIHSS, coagulation index, hematocrit, platelet aggregation rate and clinical efficacy were observed in 2 groups before and after treatment. RESULTS： After 14 d treatment, NIHSS of observation group [（3.57 ＋ 0.25） points] was significantly lower than that of control group [（5.98 ±1.13） points], with statistical significance （P〈0.05）; after treat- ment, total effective rate of observation group （81.58%） was significantly higher than that of control group （57.89%）, with statis- tical significance （P〈0.05） ; platelet aggregation rate [（52.38 ± 3.74）%] and hematocrit [（36.21± 3.26）%] of observation group were significantly lower than those of control group, with statistical significance （P〈0.05）. Before and after treatment, coagula- tion indexes of both groups had no significant change, without statistical significance （P〉0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS ： Shuxuetong combined with butylphthalide is effective in the treatment of elderly acute massive cerebral infarction, and help restore neurological function with good safety.