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目的探讨急诊机械辅助动脉溶栓联合丹红注射液治疗心源性脑栓塞的临床效果。方法将58例心源性脑栓塞患者随机分为治疗组和对照组。对照组单纯使用机械辅助动脉溶栓,治疗组在进行机械辅助动脉溶栓治疗的基础上联合应用中药丹红注射液治疗,评估2组治疗后NIHSS评分、GCS评分、Barthel指数(BI)优率、mRS评分≤2分比例,症状性颅内出血率及病死率。结果 2组治疗后的NIHSS评分均明显下降、GCS评分均较治疗前明显提高(P<0.05),且治疗后2周组间NIHSS评分、GCS评分比较差异具明显统计学意义(P<0.05)。治疗后30 d 2组BI评分优级比例及治疗后90 d m RS评分≤2分比例比较,对照组明显低于治疗组(P<0.05)。治疗组的症状性颅内出血率明显低于对照组,但2组90 d病死率比较差异无统计学意义(P>0.05)。结论联合应用机械辅助动脉溶栓和丹红注射液治疗心源性脑梗塞可明显降低其发生出血性转化的风险,改善心源性脑栓塞的神经功能缺损,提高其临床疗效,改善远期预后。
Objective To investigate the clinical effect of emergency mechanical aortic thrombolysis combined with Danhong injection in the treatment of cardiogenic cerebral embolism. Methods Fifty-eight patients with cardiogenic cerebral embolism were randomly divided into treatment group and control group. The control group was treated with mechanical aortic thrombolysis only. The treatment group was treated with Danhong injection on the basis of mechanical aortic thrombolysis. The NIHSS score, GCS score, Barthel index (BI) , MRS score ≤ 2 points, symptomatic intracranial hemorrhage and mortality. Results The scores of NIHSS were significantly decreased in both groups after treatment, and the scores of GCS were significantly higher than those before treatment (P <0.05). The scores of NIHSS and GCS between the two groups after treatment were significantly different (P <0.05) . After 30 days of treatment, the scores of superior grade in BI group and RSD score ≤2 in 90 d after treatment were significantly lower in the control group than those in the treatment group (P <0.05). Symptomatic intracranial hemorrhage in the treatment group was significantly lower than the control group, but the two groups 90d mortality was no significant difference (P> 0.05). Conclusion The combination of mechanical aortic thrombolysis and Danhong injection in the treatment of cardioembolic cerebral infarction can significantly reduce the risk of hemorrhagic transformation, improve neurological deficits of cardiogenic cerebral embolism, improve its clinical efficacy and improve long-term prognosis .