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目的观察分析羟乙基淀粉扩容治疗大脑中动脉狭窄致内分水岭脑梗死的临床疗效。方法 72例大脑中动脉狭窄所致内分水岭脑梗死患者,随机分为对照组与观察组,每组36例。对照组患者进行常规抗血小板与降脂治疗,观察组在对照组基础上给予羟乙基淀粉扩容治疗。对两组患者病变侧大脑中动脉血流速度进行经颅多普勒(TCD)检测以及美国国立卫生研究院卒中量表(NIHSS)评分。结果两组患者治疗后收缩期最大峰值流速(Vs)、舒张末期血流速度(Vd)与平均血流速度(Vm)水平均显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。两组患者治疗后7、14 d的NIHSS评分均较治疗前显著降低(P<0.05);且观察组患者治疗后7 d的NIHSS评分为(6.8±2.1)分,治疗后14 d为(4.2±1.8)分,显著低于对照组的(7.6±2.3)、(6.3±2.1)分,差异具有统计学意义(P<0.05)。结论对因大脑中动脉狭窄所致的内分水岭脑梗死,采用羟乙基淀粉予以扩容治疗效果更优。
Objective To observe the clinical effect of hydroxyethyl starch expansion in treatment of cerebral infarction caused by middle cerebral artery stenosis. Methods 72 patients with cerebral infarction caused by middle cerebral artery stenosis were randomly divided into control group and observation group with 36 cases in each group. Control group patients with conventional anti-platelet and lipid-lowering treatment, the observation group on the basis of the control group given hydroxyethyl starch dilatation therapy. Transcranial Doppler (TCD) was performed on the lesion side of the middle cerebral artery in both groups and NIH Stroke Scale (NIHSS) was scored. Results The peak systolic velocity (Vs), end-diastolic velocity (Vd) and mean velocity of vomit (Vm) in both groups after treatment were significantly higher than those before treatment (P <0.05), and the observation group was significantly higher than Control group (P <0.05). The NIHSS scores of the two groups were significantly lower than those before treatment (P <0.05) at 7 and 14 days after treatment. The NIHSS score of the observation group was (6.8 ± 2.1) on the 7th day after treatment and (4.2 ± 1.8), which was significantly lower than that of the control group (7.6 ± 2.3) and (6.3 ± 2.1), respectively. The difference was statistically significant (P <0.05). Conclusions For internal watershed cerebral infarction caused by stenosis of middle cerebral artery, the use of hydroxyethyl starch to dilate the tumor is more effective.