局部灌注瑞替普酶溶栓在高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中的效果与安全性研究  

Local perfusion rui at enzyme thrombolysis therapy in high-risk patients with pulmonary embolism menstruation in the pulmonary artery catheter broken bolt effect and safety of interventional treatment

作　　者：罗祥 宋韵 郭春丽 和建武 秦皓[2] LUO Xiang;SONG Yun;GUO Chunli(Tongchuan People’s Hospital in Shaanxi Provincs(Tongchuan 727000))

机构地区：[1]陕西省铜川市人民医院,铜川727031 [2]西安交通大学第一附属医院,西安710061

出　　处：《陕西医学杂志》2019年第2期266-269,共4页Shaanxi Medical Journal

摘　　要：目的:探讨高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中,局部灌注瑞替普酶(r-PA)溶栓治疗的效果与安全性。方法:选取符合研究标准的54例高危肺动脉栓塞住院患者,随机分为对照组24例和治疗组30例,患者均行一般治疗、低分子肝素钠抗凝治疗、介入碎栓治疗和经介入治疗对照组给予局部灌注阿替普酶溶栓治疗,治疗组则给予局部灌注瑞替普酶溶栓治疗。结果:(1)两组溶栓治疗3d后血流变(HR)和风湿因子(RF)明显减慢,动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)和血氧饱和度(SaO_2)等血气分析指标也较前明显改善,两组各自溶栓前、后指标比较差异具有统计学意义(P<0.05),其中治疗组(瑞替普酶)溶栓后差异较对照组(阿替普酶)更为显著。(2)溶栓3d后,治疗组30例中,治愈30.00%,显效50.00%,无效13.33%,无恶化和死亡病例,总治疗效果有效率为86.67%;对照组24例中,治愈25.00%,显效50.00%,无效25.00%,其中恶化1例(4.17%),无死亡病例,总治疗效果有效率75.00%。治疗组治愈率30.00%显著高于对照组25.00%(P<0.05);治疗组总治疗效果有效率86.67%显著高于对照组75.00%(P<0.05)。(3)溶栓治疗后,治疗组出血率13.33%,对照组出血率12.50%,两组溶栓治疗后出血率比较差异无统计学意义(P>0.05)。结论:局部灌注瑞替普酶溶栓治疗在高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中疗效好,安全性高。Objective:To explore the high risk patients with pulmonary embolism is passing a pulmonary artery catheter broken bolt in the interventional treatment, evaluation of regional perfusion rui at enzyme (r-PA) thrombolytic effect and safety of treatment.Methods:Selected 54 high risk as the research object, up to the study standard hospitalized patients with pulmonary embolism and 24 cases were randomly divided into control group and treatment group 30 cases, patients with general treatment and low molecular heparin sodium anticoagulation therapy, interventional broken bolt and the intervention group at o give local perfusion thrombolysis enzyme treatment; Experimental group was given local perfusion at enzyme thrombolysis treatment. Results:①Two groups of subjects three days after thrombolysis treatment of HR and RF slowed significantly, PaO 2 , SaO 2 and PaCO 2 also improved significantly earlier blood gas analysis index, index of two groups before and after each cell (bolt differences statistically significant ( P <0.05), the experimental group (at enzyme) difference of which was more significant than the control group after thrombolysis.②Three days after thrombolysis, the experimental group 30 cases, cure 30.00%, had marked effect 50.00%, invalid 13.33%, it had no deterioration and death cases, the treatment effective rate was 86.67%; Control group 24 cases, cure 25.00%, had marked effect 50.00%, invalid 25.00%, the deterioration in 1 case (4.17%), no deaths, 75.00% of the total therapeutic effect efficiently. Experimental group cure rate 30.00% is significantly higher than the control group 25.00%( P <0.05); The experimental group 86.67% of the total therapeutic effect efficiently is significantly higher than the control group 86.67%( P <0.05).③After thrombolysis treatment, the experimental group hemorrhage rate was 13.33%, the control hemorrhage rate was 12.50%, including bleeding rate difference between the two groups after thrombolysis treatment has no statistical significance( P >0.05), the hemorrhage p

关 键 词：瑞替普酶 肺动脉栓塞 经肺动脉内导管碎栓介入治疗 疗效 溶栓 并发症 

分 类 号：R563.5[医药卫生—呼吸系统]