利伐沙班联合低分肝素钙治疗晚期肺癌合并肺栓塞效果  

Clinical analysis of levashaban combined with low score heparin calcium in the treatment of advanced lung cancer complicated with pulmonary embolism

作　　者：梁柳丹 林明宽 周韶璋[2] 汪英男 LIANG Liu-Dan;LIN Ming-Kuan;ZHOU Shao-Zhang(Department of Oncology,Sanya People＇s Hospital,Sanya 530021,Hainan,China)

机构地区：[1]三亚市人民医院肿瘤内科,海南三亚530021 [2]广西医科大学附属肿瘤医院化疗二科 [3]乌兰察布市中心医院老年病科

出　　处：《中国老年学杂志》2018年第18期4385-4387,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81260357; 81060188);广西自然科学基金资助项目(2015GXNSFAA139162);内蒙古自然科学基金面上项目(2016MS0844)

摘　　要：目的探讨利伐沙班联合低分子肝素钙治疗肺癌合并急性非大面积肺栓塞的临床效果。方法肺癌合并急性非大面积肺栓塞患者80例随机分为治疗组和对照组各40例。对照组给予低分子肝素钙皮下注射和口服华法林序贯治疗,根据国际标准化比值(INR)调整剂量;治疗组给予低分子肝素钙皮下注射,口服利伐沙班10 mg,1次/d。比较两组治疗前和治疗后第1周、第1个月、第2个月的血气分析参数、超声心动图参数。结果治疗组治疗后第1周、第1个月、第2个月超声心动图血流动力学、对照组治疗后第1个月、第2个月超声心动图血流动力学和治疗前有统计学差异(P<0. 05)。治疗组和对照组治疗后第1周、第1个月、第2个月肺动脉收缩压、肺动脉平均压、右心房平均压有统计学差异(P<0. 05);治疗组和对照组治疗后第1周右心房平均压、肺循环阻力有统计学差异(P<0. 05);治疗组和对照组治疗后第1周右心室射血分数、肺循环阻力有统计学差异(P<0. 05)。两组不良反应无统计学差异(P>0. 05)。结论利伐沙班联合低分子肝素钙治疗晚期肺癌合并肺栓塞的效果优于华法林组,并且利伐沙班起效快,出血风险小,疗效安全。Objective To explore the clinical efficacy of levashaban combined with low molecular heparin calcium on the treatment of lung cancer complicated with acute non large area pulmonary embolism.Methods 80 patients with lung cancer complicated with acute non large area pulmonary embolism were randomly divided into treatment and control groups,40 cases in each group.The control group was given low molecular heparin calcium and warfarin,the treatment group was given low molecular heparin and levashaban. Blood gas analysis parameters and echocardiographic parameters were compared between the two groups before and after treatment.Results At the first week,the first month and the second month after treatment in treatment group and the first month and the second month after treatment in control group,the hemodynamics and echocardiography parameters were significantly higher than those before treatment（ P〈0.05）. The pulmonary artery systolic pressure,mean pulmonary artery pressure and right atrial mean pressure in treatment group were significantly different from those in control group at the first week,the first month and the second month respectively（ P〈0.05）. The mean pressure of the right atrium and pulmonary vascular resistance in treatment group were significantly higher than those in control group at the first week（ P〈0.05）. There were significant differences in pulmonary vascular resistance and right ventricular ejection fraction（ P〈0.05） between treatment and control groups at the first week after treatment. There was no significant difference in adverse reactions between the two groups. Conclusions The effect of levashaban combined with low molecular heparin in the treatment of advanced lung cancer with pulmonary embolism is better than that of warfarin,and the effect of levashaban is fast,the risk of bleeding is smaller and the curative effect is safe.

关 键 词：利伐沙班片 低分子肝素钙 晚期肺癌 肺栓塞 

分 类 号：R73[医药卫生—肿瘤]