华法林联合方案治疗肥胖型患者脑静脉窦血栓形成

Warfarin Combined Treatment in Obese Patients with Cerebral Venous Sinus Thrombosis

目的 观察华法林联合方案治疗肥胖型患者脑静脉窦血栓形成的效果及安全性。方法 以我院2011年3月～2015年3月收治75例肥胖型患者脑静脉窦血栓形成作为研究对象,随机数字表法分为观察组（n=38）与对照组（n=37）。两组首先均予以保护脑组织、抗感染、抗癫痫、甘露醇降颅压、改善脑部血管循环等常规对症治疗,对照组在此基础上应用华法林,观察组则采取华法林联合方案（包括低相对分子质量肝素与强化降脂）,比较两组治疗前后血脂指标（TC、TG、LDL-C、HDL-C）、恢复良好率及不良反应发生率。结果 两组治疗前各项血脂指标的比较无统计学意义（P〉0.05）,经治疗后对照组血脂指标均无明显变化,前后组间差异无统计学意义（P〉0.05）,观察组TC与LDL-C均获得降低,前后差异有统计学意义（P〈0.05）。观察组恢复良好率为94.7%（36/38）,明显高于对照组73.0%（27/37）（P〈0.05）。观察组不良反应发生率为13.2%（5/38）,对照组为10.8%（4/37）（P〉0.05）。结论 华法林联合方案治疗肥胖型患者脑静脉窦血栓形成可通过改善患者血脂指标使恢复率提高,且安全好。

Objective To observe the effect and tients with cerebral venous sinus thrombosis. Methods safety of warfarin combined treatment in the obese pa- 75 obese patients with cerebral venous sinus thrombo- sis treated in our hospital from March 2011 to March 2015 were taken as the research objects. According to the random number table method, the patients were divided into the observation group （ n = 38 ） and the control group（ n = 37）. The two groups were firstly treated with routine symptomatic treatment, such as the protection of brain tissues, anti- infection, anti- epilepsy, mannitol reducing intracranial pressure and improvement of cere- bral vascular circulation. Based in this, the control group was treated with warfarin, while the observation group was treated with warfarin combined treatment（ including low molecular weight heparin and intensive lipid-low- ering）. The blood lipid indexes （TC, TG, LDL-C, HDL-C）, good and excellent rate of recovery and adverse re- actions were compared between the two groups before and after the treatment. Results Before the treatment, there were no statistically significant differences in the blood lipid indexes between the two groups （P 〉 0. 05）. After the treatment, there was no obvious changes of the blood lipid indexes. The before and after differences between groups were not statistically significant （ P 〉 0. 05 ）. Both LDL- C and TC of the observa- tion group were decreased. The before and after differences were statistically significant（P 〈 0. 05 ）. The good and excellent rate of recovery in the observation group[94. 7% % （36/38）] was significantly higher than that of the control group [ 73.0% （ 27/37 ） ] （ P 〈 0. 05 ）. The incidence of adverse reactions in the observation group was 13.2% （5/38） ,while in the control group was 10. 8% （4/37） （P 〉 0. 05）. Conclusion Warfarin combined treatment of obese patients with cerebral venous sinus thrombosis can enhance the curative effect by improving the blood lipid indicators in patients. The good and excellent rate of recovery can be improved and the safety is high.