Study On Treatment Of Cerebral Watershed Infarction Clinical Curative Effect Of Hydroxyethyl Starch

Objective To evaluate the clinical effect of hydroxyethyl starch treatment for cerebral watershed infarction,in order to provide the clinical theory for the individual treatment.To analyze the clinical efficacy of hydroxyethyl starch in patients with different types of cerebral watershed infarction and the relationships between the CWI types and extra-intracranial vascular stenosis.Methods Methods 93 patients with CWI who were hospitalized in October 2010 May-2016 were enrolled in this study.All the subjects met the criteria for cerebrovascular disease diagnosis at the fourth session of the cerebrovascular Academic Conference.The standard of onset within 24 hours after brain magnetic resonance(MRI)routine examination combined with diffusion weighted imaging(DWI)examination technique of patients diagnosed with CWI,there are clear clinical symptoms and signs associated with the onset of infarction,and history of stroke but did not have significant neurological damage,to exclude systemic hypoperfusion,cardiogenic embolism,autoimmune diseases,cerebral hemorrhage,tumor and hydroxyethyl starch allergic patients.All patients underwent the extracranial internal carotid artery(ICA)ultrasonography and intracranial cerebralvascular MRA examinations.93 patients with cerebral watershed infarction divided into two groups in random : experimental group(n =50)and control group(n=43).Patients in experimental group were given to 6% medium molecular hydroxyethyl starch injection 130/0.4 500 ml ivdrip qdx14 d expanding blood volume treatment in addition to a routine therapy including antiplatelet、brain cell protection.Patients in control group were given to a routine therapy.National Institutes of Health Stroke Scale(NIHSS)score assessed all patients on admission、7days of treatment and 14 days of treatment.Results 1.There are no statistically significant difference in the two groups of age,sex,CWI types,the history of hypertension,coronary heart disease,diabetes,hyperlipemia smoking and drinking(P>0.05).2.On admission,there are no significant differences between the NIHSS scores of the two group(P>0.05).at 7days and 14 days after treatment,the neurological recovery of experimental group was significantly better than control group(P<0.05),and at thesame time total efficiency of experimental group was significantly higher than control group(P < 0.05).Two types of watershed cerebral infarction patients in the experimental group neural functional recovery was statistically difference(P < 0.05).hydroxyethyl starch expansion treatment of internal watershed infarction is better than the cortical watershed infarction.3.There are different in the incidence of the vascular stenosis to the lesions in the different types of CWI.CWSI often combined with the ICA stenosis ipsilateral to the lesions(OR,0.019;95% CI,0.003~0.227;P=0.016);IWSI often combined with the MCA stenosis ipsilateral to the lesions(OR,39.271;95% CI,3.179~399.818;P=0.021).Conclusion 1.Hydroxyethyl starch expanding blood volume in the treatment of cerebral watershed infarction has better clinical efficacy and can improve the nerve function defect degree.Neural functional recovery of internal watershed infarction is better than the cortical watershed infarction.2.Stenoses of large cerebral artery have important relationship with the occurrence of cerebral watershed infarction.There were different in the incidence of the lesion side ICA、MCA stenosis in the different types of CWI.CWSI is associated with lesion side of ICA stenosis,and IWSI is more with MCA stenosis.