羟乙基淀粉40氯化钠注射液联合低分子肝素治疗急性分水岭脑梗死的临床研究

肖彧　彭慕立　苏赤

【摘要】 目的：研究急性分水岭脑梗死（ACWI）患者采用羟乙基淀粉40氯化钠注射液联合低分子肝素治疗的临床效果。方法：选取2015年6月-2017年6月本院收治的急性ACWI患者86例。按随机数字表法将其分为对照组和联合组，各43例。对照组给予常规治疗，联合组在对照组基础上给予羟乙基淀粉40氯化钠注射液联合低分子肝素治疗，均治疗7 d。观察两组治疗效果、神经功能、生活质量及不良反应。结果：联合组总有效率为95.35%，明显高于对照组的79.07%（P<0.05）；联合组不良反应发生率为4.65%，明显低于对照组的18.60%（P<0.05）；治疗后，联合组NIHSS、ADL评分均优于对照组，比较差异均有统计学意义（P<0.05）。结论：羟乙基淀粉40氯化钠联合低分子肝素对急性ACWI患者治疗效果较好，明显改善神经功能和生活质量，不良反应较低，值得临床应用及推广。

【关键词】 低分子肝素； 分水岭脑梗死； 羟乙基淀粉40氯化钠

Clinical Research of Hydroxyethyl Starch 40 Sodium Chloride Injection and Low Molecular Heparin in the Treatment of ACWI/XIAO Yu，PENG Muli，SU Chi，et al.//Medical Innovation of China，2018，15（16）：0-033

【Abstract】 Objective：To explore the clinical effect of Hydroxyethyl Starch 40 Sodium Chloride Injection and low molecular heparin in the treatment of acute cerebral watershed infarction（ACWI）.Method：A total of 86 patients with acute ACWI treated in our hospital from June 2015 to June 2017 were selected.According to the random number table method，they were divided into control group and combined group，43 cases in each group.The control group was given routine treatment，and combined group was treated with Hydroxyethyl Starch 40 Sodium Chloride Injection and low molecular heparin on the basis of control group，and all of them were treated for 7 d.The therapeutic effects，neurological function，quality of life and adverse reactions were observed in two groups.Result：The total effective rate of combined group was 95.35%，which was significantly higher than 79.07% of control group（P<0.05）.The incidence of adverse reactions in combined group was 4.65%，which was significantly lower than 18.60% of control group（P<0.05）.After treatment，the NIHSS and ADL scores of combined group were all better than those of control group，the differences were statistically significant（P<0.05）.Conclusion：The combined therapy of Hydroxyethyl Starch 40 Sodium Chloride Injection and low molecular heparin has an obvious effect in ACWI patients，can greatly improve their neurological function and life quality and reduce the adverse event rate，which is worthy of clinical application and popularization.

【Key words】 Low molecular heparin； ACWI； Hydroxyethyl Starch 40 Sodium Chloride Injection

First-authors address：Gaoyao District Peoples Hospital，Zhaoqing 526060，China

doi：10.3969/j.issn.1674-4985.2018.16.009

分水岭脑梗死（ACWI）是临床上脑梗死的一种类型，分为皮层分水岭区和脑内分水岭区梗死。皮层分水岭梗死包括皮层前型和皮层后型，主要指大脑中动脉与大脑前或后动脉供血交界区的脑梗死[1]，皮质前型主要表現为以上肢为主的中枢性偏瘫，皮质后型主要表现为皮质盲或对侧感觉障碍。脑内分水岭梗死是指皮层支与深穿支间供血交界区的脑梗死，临床主要表现为纯运动性轻偏瘫和/或感觉障碍不自主运动。近年来研究发现，ACWI发病机制是由多种原因共同作用导致的结果[2]。目前研究认为，羟乙基淀粉40氯化钠与低分子肝素对ACWI患者具有治疗效果[3]。本文对本院ACWI患者采用羟乙基淀粉40氯化钠联合低分子肝素治疗，探讨治疗效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2015年6月-2017年6月本院收治的急性ACWI患者86例。（1）纳入标准：①经CT、MRI等检查和诊断符合急性ACWI诊断标准[4]；②均自愿参加本次研究；……