ABSTRACT
Objective To observe the clinical efficacy of Xingnaojing combined with butylphthalide in the treatment of vascular dementia (VD). Methods One hundred and twenty VD patients admitted to First People's Hospital of Tongxiang from August 1st 2014 to December 1st 2017 were enrolled, all the patients were given routine treatment according to their disease conditions, 53 cases were treated by intravenous drip of butylphthalide and sodium chloride injection (100 mL containing butylphthalide 25 mg and sodium chloride 0.9 g), 100 mL once, 2 times each day (single-use group); another 67 patients were treated with Xingnaojing 20 mL added into 200 mL glucose solution intravenous drip, once a day, on the basis of the treatment in the single-use group (combined group), and both groups were treated for 4 weeks. The changes of mini-mental state examination (MMSE) and activity of daily life (ADL) scores, clinical efficacy and adverse reactions were observed before and after treatment in the two groups. Results The MMSE and ADL scores in both groups were higher after treatment than those before treatment, and the MMSE and ADL scores in the combined group were significantly higher than those in the single-use group (MMSE scores: 26.77±1.30 vs. 25.64±2.81, ADL: 74.77±3.30 vs. 59.23±4.21, both P < 0.05); the clinical efficacy of the combined group was significantly higher than that of the single-use group [97.0% (65/67) vs. 81.1% (43/53), P < 0.05], however, there was no significant difference in the incidence of adverse reactions between the combined group and the single-use group [7.5% (5/67) vs. 7.6% (4/53), P > 0.05 ]. Conclusions After treatment of VD with the combination of Xingnaojing and butylphthalide, the cognitive function and daily living ability of the patients are improved to some extent, the combined treatment is more effective than the single application of butylphthalide, and no obvious adverse reaction occurs during the therapeutic course.
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Objective To evaluate the effect of anesthesia selection on endovascular treatment for anterior circulation major vessel occlusion stroke. Methods The clinical data of patients undergoing endovascular treatment in our hospital from January 2016 to August 2016 were retrospectively reviewed. The patients were divided into general anesthesia group and conscious sedation group. Comparison of the differences in time, symptomatic intracranial hemorrhage, and 90-day functional outcome between the two groups was made. Results A total of 73 patients were included in the analysis, 34 (46.6％) in the general anesthesia group, and 39 (53.4％) in the conscious sedation group. The baseline clinical data were balanced in both groups. There was no statistically significant difference in door-to-puncture time, puncture-to-recanalization time and onset-to-recanalization time between the two groups. The postoperative systolic blood pressure was significantly decreased in the general anesthesia group ((126.29 ± 20.07) vs (139.95 ± 21.22) mmHg (1 mmHg=0.133 kPa), t=2.81, P=0.01), whereas the rate of successful reperfusion (modified thrombolysis in cerebral infarction ≥ 2b) (94.1％(32/34) vs 87.2％(34/39), χ2=0.33, P=0.57), symptomatic intracranial hemorrhage rate (17.6％(6/34) vs 10.3％(4/39), χ2=0.33, P=0.57) and good outcome (modified Rankin Scale (mRS) score≤2) at 90 days (41.2％(14/34) vs 53.8％(21/39),χ2=1.17, P=0.28) did not show statistically significant difference between the two groups. Conclusions The selection of general anesthesia or conscious sedation had no significant effect on the outcome of endovascular treatment for anterior circulation major vascular occlusion stroke. The results of the study still need to be verified by large-scale randomized controlled trial.
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Objective To study the effectiveness and safety of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis therapy for acute ischemic stroke in patients with atrial fibrillation (AF).Methods A total of 94 patients treated with intravenous rt-PA thrombolysis within 4.5 hours after cerebral stroke onset were analyzed and divided into two groups:a non-AF group (n =64) and an AF group (n =30).Another 30 acute ischemic stroke patients with AF without thrombolytic therapy were selected as a control group.The prognosis of the three groups was compared.The National Institute of Health Stroke Scale (NIHSS) was used for comparison among the three groups before therapy and 7 days after therapy.The incidences of intracerebral hemorrhage (ICH) and symptomatic ICH (SICH) were recorded.The patients were followed up for 90 days and their clinical outcomes were assessed by using the modified Rankin scale (mRS).Results There were no significant differences in the NIHSS scores among three groups before treatment (P ＞ 0.05).The NIHSS scores were significantly lower in the AF and non-AF groups 7 days after thrombolysis therapy than those before thrombolysis therapy (P ＜0.05 and P ＜0.01),and no significant difference in the NIHSS scores was found in the control group before and after therapy (P ＞ 0.05).The incidence of ICH was significantly higher in the AF group than in the non-AF group (26.7％ vs.9.4％,P ＜ 0.05).No significant difference in the incidence of SICH was found between the AF and non-AF groups (13.3％ vs.6.3％,P ＞ 0.05).The favorable prognosis rate was higher in the AF and nonAFgroups than in control group (40.0％ vs.16.7％,P＜0.05; 45.3％ vs.16.7％,P＜0.01).No significant difference in very unfavorable prognosis rate was found between the AF and non-AF groups (20.0％ vs.18.8％,P ＞0.05).Conclusions It is effective and safe of rt-PA thrombolysis therapy for acute ischemic stroke patients with AF.