摘要
目的:探讨术前低分子肝素钙治疗在缺血性烟雾病血运重建术中的作用。方法:回顾性分析郑州大学第一附属医院2015年1月至2018年12月收治的115例接受血运重建术的缺血性烟雾病患者。术前1周停用抗血小板药物,按是否改用低分子肝素钙治疗分成治疗组(n=80)和对照组(n=35)。分析两组术后临床疗效、术后再发脑梗死、短暂性脑缺血发作(TIA)、颅内出血和神经功能状况评分。结果:术后治疗组临床疗效评估优于对照组(P=0.039),术后治疗组和对照组未再发TIA的例数分别为73例(91.25%)和26例(74.28%)(P=0.034);与对照组相比,治疗组再发脑梗死例数、颅内出血发生率差异均无统计学意义(P>0.05);同时,治疗组术后神经功能状况改善明显优于对照组(P=0.036)。结论:接受血运重建的缺血性烟雾病患者术前1周停用抗血小板药物之后,改用低分子肝素钙治疗能有效预防围手术期TIA的再发风险,改善神经功能状况,提高术后临床疗效,暂未发现术后颅内出血和再发脑梗死的风险增加。
Aim:To investigate the effects of preoperative administration of low molecular heparin calcium(LMNC)in the surgical revascularization of ischemic moyamoya disease(MMD).Methods:We conducted a retrospective study on 115 patients with ischemic moyamoya disease admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2018.A total of 115 patients underwent combined revascularization.All patients were discontinued antiplatelet drugs a week before surgery.These patients were allocated into treatment group(n=80)and control group(n=35)according to whether to give LMHC or not.Postoperative clinical efficacy,the scores of Modified Rankin scale(mRs),and the number of transient ischemic attack(TIA),newly developed hemorrhage and recurrent cerebral infarction were analyzed.Results:The clinical efficacy of the treatment group was better than that of the control group(P=0.039).The number of patients without recurrent TIA in treatment group was 73(91.25%),while it was 26(74.28%)in control group(P=0.034).The number of patients with recurrent cerebral infraction and postoperative hemorrhage between the 2 groups was not significant(P>0.05).The improvement of neurological status in the treatment group was significantly better than the control group(P=0.036).Conclusion:After discontinuation of antiplatelet drugs one week before operation in patients with ischemic moyamoya disease who accepted revascularization,the use of LMHC can effectively prevent the risk of TIA during perioperative period,and improve the neurological function.No increase in the risk of intracranial hemorrhage or recurrent cerebral infraction after operation has been found.
作者
高育源
何秉征
曹磊
王晨潮
王敬
李红伟
杨波
GAO Yuyuan;HE Bingzheng;CAO Lei;WANG Chenchao;WANG Jing;LI Hongwei;YANG Bo(Department of Neurosurgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2020年第1期131-134,共4页
Journal of Zhengzhou University(Medical Sciences)
关键词
低分子肝素钙
缺血性烟雾病
术后脑梗死
短暂性脑缺血发作
颅内出血
神经功能状况
low molecular heparin calcium
ischemic moyamoya disease
postoperative cerebral infarction
transient ischemic attack
hemorrhage
neurologic status
