摘要
目的研究溶栓联合抗凝治疗急性次大面积肺血栓栓塞症的疗效。方法回顾性分析我院心内科2008年3月—2012年12月收治的急性次大面积肺血栓栓塞症患者24例,根据治疗方案的不同分为单纯抗凝组和溶栓联合抗凝组。两组患者入院后均常规给予一般处理,单纯抗凝组10例患者拒绝溶栓,故给予单纯抗凝治疗;溶栓联合抗凝组14例患者同意溶栓,采用溶栓联合抗凝治疗,均治疗10d。检测两组患者治疗前及治疗10d后PaO2和6min步行距离,并对两组患者治疗前后临床症状进行比较。结果治疗后,溶栓联合抗凝组患者PaO2和6min步行距离均高于单纯抗凝组,溶栓联合抗凝组患者呼吸困难、胸痛、发热发生率低于单纯抗凝组,差异均有统计学意义(P<0.05)。所有患者治疗后未出现重要部位出血。结论溶栓联合抗凝治疗较单纯抗凝治疗可更好地改善患者PaO2、心功能及临床症状,且不增加出血风险。
Objective To research the efficacy of thrombolysis and anticoagulation in the treatment of acute submas- sive pulmonary thromboembolism. Methods 24 patients with acute submassive pulmonary thromboembolism from March 2008 to December 2012 in our hospital were retrospectively analyzed. According to the different treatment programs, patients were divid- ed into pure anticoagulant group and thrombolysis combined with anticoagulant group. Two groups of patients were routinely given general handling after admission, the pure anticoagulant group of 10 patients refused thrombolysis, so were given anticoagulant therapy alone; The thrombolysis combined with anticoagulant group of 14 patients agreed to thrombolysis, so were given thrombol- ysis combined anticoagulant therapy, they were treated for 10d. The PaO2 and 6min walking distance of two groups were detected before and after treatment, and the occurrence of clinical manifestation of two groups were compared before and after treatment. Results After treatment, the Pa02 and 6min walking distance of thrombolysis combined with anticoagulant group were higher than those of pure anticoagulant group, the incidence of difficulty breathing, chest pain, fever of thrombolysis combined with an- ticoagulant group was lower than that of pure anticoagulant group （ P 〈 0. 05 ）. All of the patients did not appeared any hemor- rhage of important position. Conclusion Compared with pure anticoagulation therapy, thrombolysis combined with anticoagulant therapy can better improve the patients＇ blood oxygen concentration and heart function and clinical symptom, and do not increase the risk of hemorrhage.
出处
《实用心脑肺血管病杂志》
2013年第11期36-37,40,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
肺栓塞
次大面积
血栓溶解疗法
抗凝
治疗结果
Pulmonary embolism, submassive
Thrombolytie therapy
Anticoagulation
Treatment outcome
