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目的:了解脑梗死二级预防中阿司匹林的应用现状,探讨阿司匹林应用不当的原因及脑梗死复发情况。方法:本研究为现况调查,研究对象为广饶县2家二级医院诊断为脑梗死的住院患者,324例脑梗死患者分为规范应用阿司匹林组(n=121)与未规范应用组(n=203),分析从脑梗死初发到调查时应用阿司匹林的情况及其脑梗死复发情况。结果:未规范服用阿司匹林组出现阿司匹林不良反应停药或减量的有43例患者(21.18%)。患者从未被建议使用阿司匹林或只单用活血化淤类中药22例(10.84%)。因临床医师建议剂量不足或患者自行减量12例。存在禁忌症9例。其他原因4例。324例脑梗死患者中112例(34.57%)复发。规范服用阿司匹林组中18例(14.88%)复发,未规范服用阿司匹林组中94例(46.31%)复发。未规范服用阿司匹林组脑梗死复发率明显高于规范服用阿司匹林组(χ2=33.11,P<0.005)。结论:脑梗死二级预防中阿司匹林应用不足,未规范服用阿司匹林其脑梗死复发率高于规范服用阿司匹林组。
Objective: To understand the status quo of aspirin in secondary prevention of cerebral infarction and to explore the reasons for the inappropriate application of aspirin and the recurrence of cerebral infarction. Methods: The present study was conducted to investigate the prevalence of cerebral infarction in two Grade II hospitals in Guangrao County. A total of 324 patients with cerebral infarction were divided into two groups: aspirin group (n = 121) and non-standard group = 203), analyzed from the initial onset of cerebral infarction to investigate the application of aspirin and its recurrence of cerebral infarction. Results: There were 43 patients (21.18%) with aspirin adverse reactions withdrawal or reduction in the non-standardized aspirin group. Patients had never been advised to use aspirin or only 22 cases of traditional Chinese medicine (10.84%). Due to insufficient dose recommended by clinicians or patients with their own reduction in 12 cases. There are contraindications in 9 cases. Other reasons in 4 cases. Of 324 patients with cerebral infarction, 112 patients (34.57%) recurred. 18 cases (14.88%) were regurgited with Aspirin, and 94 (46.31%) did not regain aspirin. The recurrence rate of cerebral infarction in non-standard aspirin group was significantly higher than that in aspirin group (χ2 = 33.11, P <0.005). Conclusion: Aspirin is insufficiently applied in secondary prevention of cerebral infarction. The recurrence rate of aspirin in non-standard aspirin is higher than that in aspirin.