摘要
目的探讨肝素不同剂型、剂量和用法治疗急性脑梗死的确切疗效。方法大宗资料随机、双盲、对照临床研究,符合入选标准者随机分为四组,A组307例采用普通肝素钠持续静脉泵入;B组308例采用普通肝素钠12500U1次/d静脉输液;C组307例采用低分子肝素钙常规皮下注射;D组300例采用低分子右旋糖酐加丹参注射液1次/d静脉输液。3周后分别观察神经功能缺损评分、病死率、不良终点事件。结果各组总有效率分别为A组94·46%、B组86·69%、C组85·02%、D组76·33%(P<0·01),病死率分别为A组1·95%、B组4·87%、C组3·26%、D组6·08%(P<0·05)。A、B、C组出血不良事件均高于D组,但A、B、C组组间比较差异无统计学意义。静脉内使用肝素615例,仅发生3例脑出血。结论静脉内使用肝素可显著降低病死率,增加治愈好转率,较之低分子肝素和常规扩管活血类药物有更好的疗效。而普通肝素维持静脉输液较每日1次静脉输液更能尽快达到肝素化,减少肝素总用量,总体疗效最佳。静脉内使用肝素的出血并发症并未超出允许的范围。
Objective To discuss the exact curative effect of different dosage forms, dosage and method of heparin for the treatment of acute cerebral infarction. Methods By randomized, double - blind, and controlled clinical research, patients who satisfied the standard were at random divided into 4 groups： group A （307 cases） were treated with continuous venous transfusion of heparin sodium which was controlled by electric transfusion pump; group B （308 cases） were treated with hepan＇n sodium 12 500 units, once every day; group C （307 cases） were treated with low- molecular- weight heparin calcium injection（LMWHCI） and group D （300 cases） were treated with Salvia Miltiorrhiza Injection and Dextran -40, once every day. After 3 weeks, the neurological function deficit scores, the mortality, the adverse terminal events were observed. Results There were significant differences in total effective rate of four groups （ 94.46%, 86.69%, 85.02% and 76.33% respectively, P 〈 0. 01 ） and mortality （ 1.95%, 4. 87%, 3.26% and 6.08% respectively, P 〈 0.05 ）. The adverse terminal events were higher in the first 3 groups than in D group, but there were no statistical differences in the first 3 groups. Only 3 cases complicated with cerebral hemorrhage among the 615 examples. Conclusion The heparin by venous transfusion may remarkably reduce the mortality, increase cure and effective rate. Compared with LMWH and blood - activating drugs, heparin has better curative effect. Furthermore, continuous transfusion can achieve heparinization as soon as possible with the least amount and the best effect compared with injection once every day. The complications of hemorrhage didn＇t surpass the permission scope.
出处
《中国急救医学》
CAS
CSCD
北大核心
2008年第2期122-124,共3页
Chinese Journal of Critical Care Medicine
关键词
肝素化
维持抗凝
脑梗死
对照研究
Heparinization
Anti - coagulation
Cerebral infarction
Controlled study
