恶性肿瘤血液高凝状态与缺血性脑卒中的关系及护理对策

Relationship between Malignant Tumor-Related Hypercoagulability and Ischemic Stroke and the Nursing Countermeasures

目的:探讨恶性肿瘤相关缺血性脑卒中患者的血液高凝状态与缺血性脑卒中的关系及针对性的护理对策。方法:回顾性收集巴中市中心医院神经内科2019年1月至2021年8月收治的非神经系统实体恶性肿瘤相关缺血性脑卒中患者86例作为研究组,按照性别、年龄、入院时间、肿瘤类型相匹配的原则选择,分别选择86例单纯恶性肿瘤、单纯脑缺血性脑卒中作为对照组,对传统脑卒中危险因素、凝血指标等比较分析,并提出针对性护理对策。结果:恶性肿瘤相关缺血性脑卒中组患者的高血压、糖尿病的发生比例明显高于单纯恶性肿瘤组患者,差异有统计学意义(均P<0.05);恶性肿瘤相关缺血性脑卒中患者的活化部分凝血酶时间低于单纯恶性肿瘤组,而D-二聚体、血小板计数水平则高于单纯恶性肿瘤组患者,差异均有统计学意义(均P<0.05)。恶性肿瘤相关缺血性脑卒中组患者的高血压、糖尿病、高脂血症和吸烟的比例明显高于单纯缺血性脑卒中患者,差异有统计学意义(均P<0.05);恶性肿瘤相关缺血性脑卒中患者的活化部分凝血酶时间低于单纯缺血性脑卒中,而D-二聚体水平则高于缺血性脑卒中,差异均有统计学意义(均P<0.05)。结论:恶性肿瘤相关缺血性脑卒中除具有高血压、糖尿病、高脂血症等传统脑血管病的危险因素外,D-二聚体、血小板计数水平升高等血液高凝状态是其发病危险因素,在临床实践中,需要加强对恶性肿瘤相关缺血性脑卒中患者的抗凝治疗和针对性护理干预。

Objective : To explore the relationship between blood hypercoagulability and ischemic stroke in patients with malignant tumor-related ischemic stroke and relevant nursing countermeasures. Methods : 86 patients with non-nervous system solid malignant tumor-related ischemic stroke treated in the department of neurology in Bazhong Central Hospital from January 2019 to August 2021 were retrospectively collected as the study group. Another 86 patients with simple ischemic stroke and simple malignant tumor with matching gender, age, admission time and tumor type were selected as the control group. Traditional risk factors of stroke and coagulation indexes in two groups were compared and analyzed, and the corresponding nursing countermeasures were put forward. Results : The incidences of hypertension and diabetes in patients with malignant tumor-related ischemic stroke were significantly higher than those in patients with simple malignant tumor(P <0.05). The activated partial thrombin time(APTT) in the malignant tumor-related ischemic stroke group was significantly lower than that in the simple malignant tumor group, while the levels of D-dimer and platelet count in the former were significantly higher than those in the latter( all P < 0.05).The proportions of hypertension, diabetes, hyperlipidemia and tobacco use in patients with malignant tumor-related ischemic stroke were significantly higher than those in patients with simple ischemic stroke( P < 0.05). APTT in the malignant tumor-related ischemic stroke group was lower than that in the simple ischemic stroke group, while the level of D-dimer in the former was higher than that in the latter( all P < 0.05). Conclusion: In addition to risk factors of cerebrovascular diseases such as hypertension, diabetes and hyperlipidemia, the risk factors of malignant tumor-related ischemic stroke also include blood hypercoagulable state such as increased D-dimer and platelet count. In clinical practice, anticoagulant therapy and nursing interventions targeting patients with malignant tumor-related ischemic stroke need to be strengthened.