术前应用低分子右旋糖酐对老年缺血性脑血管病变颅内血管支架成形术凝血功能和炎性因子的影响

发布时间：2018-04-29 21:42

本文选题：低分子右旋糖酐 + 颅内血管支架成形术　；参考：《广东医学》2017年08期

【摘要】：目的探讨术前应用低分子右旋糖酐对颅内血管支架成形术治疗老年缺血性脑血管病变患者凝血功能和炎性因子的影响。方法选取60例存在颅内血管狭窄的老年缺血性脑血管病变患者作为研究对象,回顾性分析患者临床资料,按照治疗方案分为对照组28例和观察组32例。所有患者均行颅内血管支架成形术治疗。对照组患者给予常规治疗,观察组在对照组基础上给予低分子右旋糖酐治疗。比较两组患者手术情况,术后再狭窄发生率、手术前后Alberta卒中项目早期CT评分(ASPECTS)、凝血功能指标及炎性因子水平。结果所有患者颅内血管支架成形术均成功,手术成功率100%。观察组并发症发生率低于对照组(6.2%vs 32.1%,P0.05)。随访1年,观察组和对照组患者术后再狭窄发生率组间比较差异无统计学意义(3.1%vs 14.3%,P0.05)。术后72h,观察组ASPECTS评分高于对照组(P0.05)。术后72 h,与对照组比较,观察组凝血酶原时间、活化部分凝血酶时间、凝血酶时间延长,纤维蛋白原水平降低,白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α等炎性因子水平降低,组间比较差异均有统计学意义(P0.05)。结论术前给予低分子右旋糖酐在颅内血管支架成形术治疗老年缺血性脑血管病变中应用效果良好,能够减少术后并发症发生率,增加术后脑血流灌注,并且能够改善凝血功能,减轻炎性反应,临床上值得应用。
[Abstract]:Objective to investigate the effect of low molecular weight dextran on coagulation function and inflammatory factors in elderly patients with ischemic cerebrovascular disease. Methods 60 elderly patients with ischemic cerebrovascular disease with intracranial vascular stenosis were selected as subjects. The clinical data were retrospectively analyzed and divided into control group (n = 28) and observation group (n = 32). All patients were treated with intracranial stent angioplasty. The patients in the control group were treated with routine therapy, and the patients in the observation group were treated with low molecular weight dextran on the basis of the control group. The postoperative restenosis rate, early CT score of Alberta stroke project, coagulation function index and inflammatory factor level were compared between the two groups. Results Intracranial angioplasty was successful in all patients, and the success rate was 100%. The incidence of complications in the observation group was lower than that in the control group (6.2 vs 32.1). There was no significant difference in the incidence of restenosis between the observation group and the control group after 1 year follow-up. There was no significant difference in the incidence of restenosis between the observation group and the control group (3.1 vs 14.3P0.05). At 72 hours after operation, the ASPECTS score in the observation group was higher than that in the control group (P 0.05). At 72 hours after operation, the prothrombin time, activated partial thrombin time, fibrinogen level, IL-8, tumor necrosis factor- 伪 and other inflammatory factors were decreased in the observation group compared with those in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion preoperative application of low-molecular-weight dextran in the treatment of senile ischemic cerebrovascular disease is effective, which can reduce the incidence of postoperative complications, increase cerebral blood perfusion, and improve coagulation function. It is worthy of clinical application to alleviate inflammatory reaction.
【作者单位】：西安交通大学医学院附属汉中三二○一医院神经外科;延安大学医学院生物化学与分子生物学教研室;
【分类号】：R651.12

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