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目的分析低分子肝素钙联合纳洛酮治疗急性脑梗死(ACI)的有效性及安全性。方法选取2015年4月—2016年10月宝鸡市中医医院收治的ACI患者80例,采用随机数字表法分为对照组和观察组,每组40例。在常规对症治疗基础上,对照组患者采用低分子肝素钙注射液治疗,观察组患者采用低分子肝素钙注射液联合盐酸纳洛酮治疗。比较两组患者治疗前及治疗后7、14 d美国国立卫生研究院卒中量表(NIHSS)评分,临床疗效,治疗前后凝血酶原时间、血小板计数、纤维蛋白原,治疗期间不良反应发生情况。结果治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗后7、14 d观察组患者NIHSS评分低于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者凝血酶原时间、血小板计数、纤维蛋白原比较,差异无统计学意义(P>0.05);治疗后观察组患者凝血酶原时间长于对照组,纤维蛋白原低于对照组(P<0.05),而两组患者血小板计数比较,差异无统计学意义(P>0.05)。观察组患者治疗期间不良反应发生率低于对照组(P<0.05)。结论低分子肝素钙联合纳洛酮治疗ACI的临床疗效确切,可有效改善患者神经功能及凝血功能,且安全性较高。
Objective To analyze the effectiveness and safety of low molecular weight heparin combined with naloxone in the treatment of acute cerebral infarction (ACI). Methods Eighty ACI patients were enrolled in Baoji TCM Hospital from April 2015 to October 2016. The patients were divided into control group and observation group with 40 cases in each group by random number table. On the basis of conventional symptomatic treatment, the control group of patients treated with low molecular weight heparin injection, the observation group of patients with low molecular weight heparin calcium injection combined with naloxone hydrochloride treatment. The National Institutes of Health Stroke Scale (NIHSS) score, clinical efficacy, prothrombin time, platelet count, fibrinogen, adverse reactions during and after treatment were compared between the two groups before and 7 and 14 days after treatment. Results There was no significant difference in NIHSS scores between the two groups before treatment (P> 0.05). NIHSS scores of observation group were lower than those of control group on the 7th and 14th day after treatment (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Prothrombin time, platelet count and fibrinogen in the two groups before treatment were not statistically different (P> 0.05). Prothrombin time in the observation group was longer than that in the control group and fibrinogen was lower than the control group P <0.05). There was no significant difference in platelet count between the two groups (P> 0.05). The incidence of adverse reactions in observation group was lower than that in control group (P <0.05). Conclusion Low molecular weight heparin combined with naloxone in the treatment of ACI has definite curative effect and can effectively improve the neurological function and coagulation function in patients with high safety.