颈动脉内膜剥脱术对缺血性脑卒中患者神经功能和凝血功能的影响

Effect of CEA on neurological function and coagulation function in patients with ischemic stroke

目的观察颈动脉内膜剥脱术(CEA)对缺血性脑卒中患者的治疗效果,及对患者神经功能和凝血功能的影响。方法回顾性选取2017年2月至2017年12月在本院接受治疗的90例缺血性脑卒中患者为研究对象,根据其治疗方式分为颈动脉支架成型术(CAS)组45例和CEA组45例。观察两组患者的治疗效果,比较两组患者治疗前后凝血功能、生活质量的差异。结果CEA组患者治疗有效率为97.78%,明显高于CAS组(84.44%,χ^2=4.939,P=0.026)。两组患者治疗前凝血功能比较差异无统计学意义(P>0.05);治疗后,CEA组患者的活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、D二聚体(D-D)水平低于CAS组(t=22.801、3.752、6.039、169.556,P<0.05)。两组患者治疗前生活质量评分比较差异无统计学意义(P>0.05);治疗后,CEA组患者的生活质量评分高于CAS组(P<0.05)。CEA组患者高灌注综合征、再狭窄、血肿发生率较CAS组低(6.67%vs 22.22%,χ^2=4.406,P=0.036)。结论颈动脉内膜剥脱术(CEA)对缺血性脑卒中患者有较好的治疗效果,可明显改善患者的神经功能和凝血功能,具有良好的应用价值。

Objective To observe the effect of carotid endarterectomy(CEA)on the patients with ischemic stroke,and to observe the effect on the function of nerve and blood coagulation.Methods The patients who were treated with ischemic stroke in our hospital from February 2017 to December 2017 were selected as the research subjects.According to the treatment methods,the patients were divided into the carotid angioplasty stenting(CAS)group(n=45)and the CEA treatment group(n=45).The therapeutic effects of the two groups were observed,and the differences of coagulation function and quality of life between the two groups before and after treatment were compared.Results The effective rate of treatment in the CEA treatment group was 97.78%,which was significantly higher than that of the CAS group(χ^2=4.939,P=0.026).The two groups had no difference in coagulation function before treatment.After the treatment,the levels of activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)and D-dimer(D-D)in the CEA group were lower than those in the CAS group(t=22.801,3.752,6.039,169.556,P<0.05).There was no difference in the quality of life between the two groups before treatment.After treatment,the quality of life of the CEA treatment group was higher than that of the CAS group(P<0.05).The incidence of high perfusion syndrome,restenosis and hematoma in group CEA was lower than that in group CAS(χ^2=4.406,P=0.036).Conclusions CEA has good therapeutic effect on patients with ischemic stroke.It can obviously improve the nerve function and coagulation function of patients,and has a good application value.