注射用降纤酶联合银杏达莫注射液治疗急性次大面积肺栓塞的临床疗效观察  

Clinical Effect of Defibrase for Injection Combined with Ginkgo Dipyridolum Injection on Acute Sub-massive Pulmonary Embolism

作　　者：王宝锋[1] 关敏[2] 

机构地区：[1]陕西省宝鸡市中心医院呼吸内科,721008 [2]陕西省宝鸡市中心医院感染性疾病科,721008

出　　处：《实用心脑肺血管病杂志》2017年第8期112-116,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察注射用降纤酶联合银杏达莫注射液治疗急性次大面积肺栓塞(ASPE)的临床疗效。方法选取2015年5月—2016年5月宝鸡市中心医院收治的ASPE患者94例,采用随机数字表法分为对照组和观察组,每组47例。在常规及对症治疗基础上,对照组患者给予银杏达莫注射液治疗,观察组患者在对照组基础上加用注射用降纤酶治疗,两组患者均连续治疗2周。比较两组患者临床疗效,治疗前后实验室检查指标[心肌肌钙蛋白I(c Tn I)、脑钠肽(BNP)、D-二聚体]、动脉血气分析指标{动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、肺泡动脉血氧分压差[P(A-a)O_2]}及右心功能指标(肺动脉压、右房室瓣反流差压、右心房内径、右心室内径),并观察两组患者治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者血清cTnI、BNP、D-二聚体水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清cTnI、BNP、D-二聚体水平低于对照组(P<0.05)。治疗前两组患者PaO_2、PaCO_2、P(A-a)O_2比较,差异无统计学意义(P>0.05);治疗后观察组患者PaO_2高于对照组,PaCO_2、P(A-a)O_2低于对照组(P<0.05)。治疗前两组患者肺动脉压、右房室瓣反流差压、右心房内径、右心室内径比较,差异无统计学意义(P>0.05);治疗后观察组患者肺动脉压、右房室瓣反流差压低于对照组,右心房内径、右心室内径小于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论注射用降纤酶联合银杏达莫注射液治疗ASPE的临床疗效确切,可有效缓解患者临床症状,改善血液高凝状态及患者右心功能,安全性较高。Objective To observe the clinical effect of defibrase for injection combined with ginkgo dipyridolum injection on acute sub-massive pulmonary embolism. Methods A total of 94 patients with acute sub-massive pulmonary embolism were selected in the Central Hospital of Baoji from May 2015 to May 2016,and they were divided into control group and observation group according to random number table, each of 47 cases. Based on conventional and symptomatic treatment,patients of control group received ginkgo dipyridolum injection,while patients of observation group received defibrase for injection combined with ginkgo dipyridolum injection; both groups continuously treated for 2 weeks. Clinical effect,laboratory examination results（ including cTnI,BNP and D-dimer）,blood-gas analysis results [including PaO2,PaCO2 and P（ A-a）O2]and index of right heart function（ including pulmonary artery pressure,right atrioventricular valve countercurrent flow differential pressure,right atrial inner diameter and right ventricular diameter） before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment. Results Clinical effect of observation group was statistically significantly better than that of control group（ P〈0. 05）. No statistically significant differences of serum level of c Tn I,BNP or D-dimer was found between the two groups before treatment（ P〉0. 05）,while serum levels of cTnI,BNP and D-dimer of observation group were statistically significantly lower than those of control group after treatment（ P〈0. 05）. No statistically significant differences of PaO2,PaCO2 or P（ A-a）O2 was found between the two groups before treatment（ P〉0. 05）; after treatment,PaO2 of observation group was statistically significantly higher than that of control group,while PaCO2 and P（ A-a）O2 of observation group were statistically significantly lower than those of control group（ P〈0. 05）. No statistically significant differences of pulmonar

关 键 词：肺栓塞 注射用降纤酶 银杏达莫注射液 治疗结果 

分 类 号：R563.5[医药卫生—呼吸系统]