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作 者:朱良华[1] 方长太[1] 白兆青[1] 任小梅[1]
机构地区:[1]安徽医科大学附属安庆医院,安徽安庆246003
出 处:《安徽医药》2015年第1期166-168,共3页Anhui Medical and Pharmaceutical Journal
摘 要:目的中危肺栓塞的治疗方案是采用溶栓治疗还是抗凝治疗,学术界争议较大。该研究拟探讨溶栓与抗凝对中危肺血栓栓塞患者的疗效、安全性及长期预后的影响。方法回顾性分析2008年1月至2013年5月因中危肺血栓栓塞于该院治疗的患者48例,采用溶栓治疗25例,单纯抗凝治疗23例;比较两组患者的疗效、安全性及长期预后。结果溶栓组治疗总体有效率为96.00%,抗凝组总体有效率为60.87%(P<0.05)。溶栓组、抗凝组各有1例患者出现大出血事件;溶栓组5例出现小出血事件,抗凝组4例小出血事件(P>0.05)。长期随访,溶栓组肺血栓栓塞再发率为4.0%;抗凝组肺血栓栓塞再发率为8.7%(P>0.05)。结论针对无溶栓治疗禁忌证的中危肺血栓栓塞患者,尽管溶栓费用较抗凝治疗为高,但其疗效好,且副作用与单纯抗凝治疗类似,安全性良好,宜作为临床首选。Objective To compare the effect and prognosis between thrombolytic and anticoagulation therapy in patients with intermedi-ate-risk pulmonary thromboembolism.Methods The short-term and long-term data of 48 consecutive patients with intermediate-risk pulmonary thromboembolism between January 2008 and May 2013 were retrospectively reviewed.Among them,25 patients underwent thrombolysis and 23 patients underwent anticoagulation therapy only.The primary endpoints were efficacy,safety and prognosis.Results The effective rate was significantly higher in patients undergoing thrombolysis than in patients undergoing anticoagulation alone (96.00% vs 60.87%,P 〈0.05).There were no significant differences in bleeding events (P 〉0.05)and prognosis(P 〉0.05)be-tween the two groups.Conclusions Thrombolysis can improve the clinical course of patients who have intermediate-risk pulmonary thromboembolism without contraindication of thrombolysis and do not increase bleeding events.
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