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Objective:To investigate the efficacy and safety of new oral anticoagulants in the treatment of elderly patients with non-valvular atrial fibrillation.Methods:From March 2016 to September 2018, 176 elderly patients with non-valvular atrial fibrillation admitted to Lyucheng Cardiovascular Hospital of Zhejiang Province were selected and divided into warfarin group(56 cases), dabiga group(64 cases) and rivaroxaban group(56 cases) according to the treatment conditions.All three groups were treated for 6 months.The incidence of embolism and bleeding events, the changes of blood sugar and liver, kidney function before and after treatment in three groups were compared.Results:The incidence rates of thromboembolism in the warfarin group, dabiga group and rivaroxaban group were 7.14%(4/56), 1.56%(1/64), 3.57%(2/56), respectively, there was no statistically significant difference among the three groups( U=2.457, P>0.05). The incidences of bleeding in the warfarin group, dabiga group and rivaroxaban group were 16.07%(9/56), 3.13%(2/64), 1.79%(1/56), respectively, there was statistically significant difference among the three groups( U=11.090, P<0.05), which in the warfarin group was significantly higher than that in the dabicarbonate group and rivaroxaban group(χ 2=6.012, 7.028, all P<0.05). There were no statistically significant differences in blood sugar, lipid, liver and kidney function among the three groups before and after treatment(all P>0.05). Conclusion:Compared with warfarin, the new oral anticoagulant dapigatron ester and rivaroxaban have similar effects in preventing stroke and thromboembolism in elderly patients with non-valvular atrial fibrillation, while the risk of bleeding events during the administration of dapigatron ester and rivaroxaban is lower, suggesting that the new oral anticoagulant is effective in the treatment of stroke and thromboembolism in elderly patients with non-valvular atrial fibrillation.The therapy has high efficacy and safety, which is worthy of clinical promotion.
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Objective:To investigate the clinical efficacy of sakubattral and valsartan sodium tablets in the treatment of heart failure and its effect on cardiac function and serum B-type natriuretic peptide(BNP).Methods:From December 2017 to February 2019, 102 patients with heart failure admitted to Lyucheng Cardiovascular Hospital of Zhejiang Province were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group.The control group was treated with routine treatment, while the treatment group was treated with sakubattral and valsartan sodium tablets on the basis of routine treatment.Both two groups were treated for 12 weeks.The heart function[including left ventricular ejection fraction(LVEF), cardiac output per stroke(SV) and left ventricular end-diastolic diameter(LVEDD)], serum BNP, 6-minute walking distance(6MWD) and quality of life were compared between the two groups before and after treatment.Results:The total effective rate of the treatment group was 94.12%(48/51), which was higher than 72.55%(37/51) of the control group, the difference was statistically significant(χ 2=8.541, P<0.05). After treatment, the LVEF[(60.28±6.97)%] and SV[(78.91±4.23)mL] in the treatment group were higher than those in the control group[(52.31±4.56)% and (71.35±6.74)mL], while the LVEDD in the trentment group [(54.89±5.26)mm]was lower than that in the control group[(61.74±4.80)mm], the differences were statistically significant( t=6.834, 6.785, 6.870, all P<0.05). After treatment, the serum BNP level in the treatment group[(164.32±14.39)ng/L] was lower than that in the control group[(248.96±23.15)ng/L], while the 6MWD in the trentment group [(353.27±42.26)m] was higher than that in the control group[(273.21±34.47)m], the differences were statistically significant ( t=22.175, 10.484, all P<0.05). After treatment, the MLHFQ score in the treatment group[(27.83±5.41)points] was lower than that in the control group[(41.98±7.64)points], the difference was statistically significant( t=10.794, P<0.05). Conclusion:Sakubattral and valsartan sodium tablets has good clinical efficacy in treating heart failure, it can improve cardiac function and reduce serum BNP level, which is worthy of clinical application.
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Objective To evaluate the effect of minimally invasive therapy for treating intraventricular hemorrhage.Methods The minimally invasive therapy with unilateral or bilateral drainage were received according to quantity and shape of intraventricular hemorrhage.Results It was operated 22 cases with unilateral drainage and 28 cases with bilateral drainage in the 50 cases intraventricular hemorrhage.Death was 3 cases and mortality rate was 6% in the minimally invasive therapy.ADL1 15 cases(30%),ADL2 18 CRSeS(36%),ADL3 8 cases(16%),ADLA4 cases(8%),ADL5 2 cases(4%)in leave hospital.Conclusion Minimal invasive therapy of intraventrieular hemorrhage has great superiority,such as it can operate simple,trauma mild,decrease complications and enhance curative effect.It can generalize in the basic hospital.
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Objective - To analyze the relation between classes and prognosis of the brain.stem hemorrhage.Methods 37 patients with spontaneous brainstem hemorrhage were divided into three groups according to con-sciousness and breathing function: Ⅰ group 13 cases with consciousness; Ⅱ group 11 cases without consciousness; Ⅲgroup 13 cases without consciousness and respiration, according to the classes, using different ways and means. Re-suits Ⅰ group 13 cases survival in 13 cases; Ⅱ group 10 cases survival and 1 case death in 11 cases; Ⅲ group 1 case survival and 12 cases death in 13 eases. Conclusion The classes of the brain.stem hemorrhage is propitious to select therapeutic measure and prognostic estimate. The intensive care and the surgery can reduce mortality rate.