颅内静脉窦血栓患者行介入溶栓、抗凝联合治疗的临床效果

Clinical curative effects of interventional thrombolysis combined with anticoagulation in treatment of patients with cerebral venous sinus thrombosis

目的对颅内静脉窦血栓患者行介入溶栓、抗凝联合治疗的临床效果进行分析探讨。方法选取2007年4月~2017年4月在我院神经外科接受治疗的92例颅内静脉窦血栓患者作为研究对象,将其随机分为观察组和对照组各46例。对照组患者应用低分子肝素行抗凝治疗,观察组患者则行介入溶栓联合低分子肝素抗凝治疗。观察比较两组患者的临床治疗效果、不良反应及治疗前后凝血指标(PT、APTT、FBG)、D-二聚体(D-D)、红细胞分布宽度(RDW)的变化情况。结果经过相应的治疗之后,观察组患者治疗的总有效率为95.7%,明显高于对照组的82.6%,差异有统计学意义(P<0.05);两组患者的PT、APTT及FBG水平均较治疗前显著改善,并且观察组患者改善的更为显著,差异有统计学意义(P<0.05);两组患者的D-D、RDW水平均较治疗前显著下降,并且观察组患者下降的更为显著,差异有统计学意义(P<0.05);观察组患者的不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论颅内静脉窦血栓患者行介入溶栓、抗凝联合治疗能够获得良好的临床效果,显著改善患者的凝血指标,降低D-D、RDW水平,并且具有较高的安全性,具有重要的临床意义。

Objective To analyze and discuss the clinical curative effects of interventional thrombolysis combined with anticoagulation in treatment of patients with cerebral venous sinus thrombosis. Methods 92 patients with cerebral venous sinus thrombosis who were treated in department of neurosurgery in Huadu District People’s Hospital in Guangzhou from April 2007 to April 2017 were selected as research objects.They were randomly divided into the observation group and the control group,with 46 cases in each group.Patients in the control group were treated with anticoagulation by low molecular weight heparin while patients of observation group were treated with interventional thrombolysis combined with anticoagulation by low molecular weight heparin.The clinical curative effects,adverse reactions and changes of coagulation parameters (PT,APTT,FBG),D-dimer (D-D) and red blood cell distribution width (RDW) levels before and after treatemtn of two groups were compared. Results After corresponding treatment,the total effective rate in the observation group was 95.7%,which was significantly better than the 82.6% in the control group.Differences between groups were statistically significant (P < 0.05).The PT,APTT and FBG levels of the two groups were all significantly improved than before,and the observation group was more significantly improved (P < 0.05).The D-D and RDW levels of the two groups were all significantly decreased than before,and the observation group was more significantly decreased (P < 0.05).The incidence of adverse reactions in observation group was significantly lower than that in the control group,and the difference was statistically significant (P < 0.05). Conclusion Interventional thrombolysis combined with anticoagulation in treating patients with cerebral venous sinus thrombosis can obtain good clinical curative effects.It can significantly improve coagulation index of patients and reduce D-D and RDW levels.And it also has a high level of security,which makes it has an important clinical significance.