羟乙基淀粉40氯化钠注射液治疗进展性脑梗死疗效评估

Evaluation of curative effect by hydroxyethyl starch 40 sodium chloride injection in the treatment of progressive cerebral infarction

目的探讨分析羟乙基淀粉40氯化钠注射液治疗进展性脑梗死的临床疗效。方法 60例进展性脑梗死患者,按照治疗方法的不同将其分为对照组(给予常规治疗)以及联合治疗组(在对照组的基础上给予羟乙基淀粉40氯化钠注射液联合低分子肝素钙治疗),每组30例。比较两组患者治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、治疗效果以及不良反应发生率。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)。治疗后7、14 d,联合治疗组NIHSS评分均低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者Barthel指数比较差异无统计学意义(P>0.05)。治疗后3、6个月,联合治疗组患者Barthel指数均高于对照组,差异具有统计学意义(P<0.05)。联合治疗组总有效率为96.7%,高于对照组的80.0%,差异具有统计学意义(P<0.05)。联合治疗组不良反应发生率为3.3%,低于对照组的20.0%,差异具有统计学意义(P<0.05)。结论羟乙基淀粉40氯化钠注射液联合低分子肝素钙治疗进展性脑梗死的疗效更加显著,安全性更高,不良反应较少,值得临床推广应用。

Objective To investigate and analyze clinical effect by hydroxyethyl starch 40 sodium chloride injection in the treatment of progressive cerebral infarction. Methods A total of 60 patients with progressive cerebral infarction were divided by different treatment measures into control group（received conventional therapy） and combined treatment group（received additional hydroxyethyl starch 40 sodium chloride injection combined with low molecular weight heparin calcium to conventional therapy）, with 30 cases in each group. Comparison was made on National Institutes of Health Stroke Scale（NIHSS） score, Barthel index, curative effect and incidence of adverse reactions between the two groups before and after treatment. Results Before treatment, there was no statistically significant difference of NIHSS score between the two groups（P〉0.05）. After 7, 14 d of treatment, the combined treatment group had lower NIHSS scores than the control group, and the difference had statistical significance（P〈0.05）. Before treatment, the difference of Barthel index between the two groups had no statistical significance（P〉0.05）. After 3, 6 months of treatment, the combined treatment group had all higher Barthel index than the control group, and the difference had statistical significance（P〈0.05）. The combined treatment group had higher total effective rate as 96.7% than 80.0% in the control group, and the difference had statistical significance（P〈0.05）. The combined treatment group had lower incidence of adverse reactions as 3.3% than 20.0% in the control group, and the difference had statistical significance（P〈0.05）. Conclusion Combination of hydroxyethyl starch 40 sodium chloride injection and low molecular weight heparin calcium shows excellent curative effect, high safety and few adverse reactions in treating progressive cerebral infarction. This method is worth clinical promotion and application.