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目的探讨阿加曲班配合高压氧疗对老年缺血性脑卒中(ischemic stroke,IS)的临床效果及其对Barthel指数、神经认知功能评分及血液流变学的影响。方法以2009年4月~2012年10月期间于笔者医院神经内科住院就诊的86例IS患者为研究对象,采用随机数字表法分为对照组和观察组,每组各43例,其中对照组仅给予阿加曲班,观察组则在此基础之上加用高压氧疗。比较两组患者的临床疗效、Barthel指数、神经认知功能评分及血液流变学指标。结果观察组患者在平均住院天数和平均住院费用均显著低于对照组(P<0.05);治疗前两组患者的HDS评分、NIHSS评分、Barthel指数和血液流变学指标全血黏度切变率、血浆黏度、相对血液黏度切变率、血细胞比容、纤维蛋白原比较,差异均无统计学意义(P>0.05);但治疗结束后,两组患者的HDS评分和Barthel指数显著增高,NIHSS评分、全血黏度切变率、血浆黏度、相对血液黏度切变率和纤维蛋白原均明显下降(P<0.05);而且,观察组患者的改善程度明显优于对照组,差异均具有统计学意义(P<0.05)。结论阿加曲班配合高压氧对老年IS患者具有显著临床疗效,并能改善其自理生活能力、认知功能,降低血液黏度。
Objective To investigate the clinical effect of argatroban combined with hyperbaric oxygen therapy on senile ischemic stroke (IS) and its effect on Barthel index, neurocognitive function score and hemorheology. Methods From April 2009 to October 2012 in our hospital neurology inpatient treatment of 86 patients with IS as the research object, using random number table divided into control group and observation group, 43 cases in each group, of which the control group Only given argatroban, the observation group is based on the use of hyperbaric oxygen therapy. The clinical efficacy, Barthel index, neurocognitive function score and hemorheology indexes of two groups were compared. Results The average hospitalization days and average hospitalization costs of the observation group were significantly lower than those of the control group (P <0.05). HDS score, NIHSS score, Barthel index and hemorheology index of the two groups before treatment were lower than those of the control group , Plasma viscosity, relative shear rate of blood viscosity, hematocrit and fibrinogen had no significant difference (P> 0.05). However, HDS score and Barthel index were significantly increased in both groups after treatment, NIHSS Grading, whole blood viscosity shear rate, plasma viscosity, relative shear rate of blood viscosity and fibrinogen were significantly decreased (P <0.05), and the observation group patients improved significantly better than the control group, the difference was statistically significant Significance (P <0.05). Conclusion Argatroban combined with hyperbaric oxygen has significant clinical effect on elderly patients with IS, and can improve their living ability, cognitive function, reduce blood viscosity.