急性中高危肺血栓栓塞症溶栓治疗效果及预后评价  

Evaluation of efficacy and prognosis of acute middle-high risk pulmonary thromboem-bolism with thrombolytic therapy

作　　者：杨楠 蒋菊 卢炜[1] 刘瑞 陈玉琴[1] 田凤军[1] Yang Nan;Jiang Ju;Lu Wei;Liu Rui;Chen Yuqin;Tian Fengjun(The 2nd Department of Respiratory Medicine,Third Hospital of Hebei Medical University,Shijiazhuang 050000,China;The 2nd Department of Internal Medicine,Shenzhou Hospital,Hengshui 053800,China)

机构地区：[1]河北医科大学第三医院呼吸2科,石家庄050000 [2]深州市医院内2科,衡水053800

出　　处：《国际呼吸杂志》2019年第11期851-855,共5页International Journal of Respiration

基　　金：河北省卫生厅重点科技研究计划(20170656).

摘　　要：目的探讨溶栓对急性中高危肺血栓栓塞症的治疗效果及预后。方法以2013年1月至2017年12月河北医科大学第三医院确诊的43例急性中高危肺血栓栓塞症患者为研究对象。溶栓组12例,接受重组组织型纤溶酶原激活剂溶栓治疗后桥接低分子肝素钠治疗;抗凝组31例,为接受低分子肝素钠单纯抗凝治疗。应用SPSS统计软件分析2组患者的病例特点、治疗效果及预后情况。结果2组患者治疗后的主要实验室指标均好于治疗前,但早期的症状及右心功能改善情况溶栓组好于抗凝组。溶栓组总出血率(41.7%)高于抗凝组(12.9%),但抗凝组随访发现肺血栓栓塞复发2例,慢性血栓栓塞性肺动脉高压1例。结论溶栓治疗的早期疗效及远期预后好于抗凝治疗,但出血风险增加。Objective To evaluate efficacy and prognosist of acute middle-high risk pulmonary thromboembolism (PTE) patients with thrombolytic therapy. Methods The clinical data about 43 patients with acute middle-high risk PTE in the Third Hospital of Hebei Medical University from January 2013 to December 2017 were retrospectively analyzed.Thrombolysis group was 12 patients with treatment of rt-PA and low molecular weight heparin sodium and anticoagulant group was 31 patients with treatment of low molecular weight heparin sodium.Data analyses was conducted with SPSS statistical software. Results The main laboratory indexes after treatment were better than those before treatment in two groups, but improvement of symptoms and right ventricular function of thrombolysis group was better than anticoagulant group.Bleeding rate of thrombolysis group (41.7%) was higher than anticoagulant group (12.9%). Two cases were PTE recrudesce in anticoagulant group.And one case was CTEPH in anticoagulant group. Conclusions Although the risk of bleeding increases, the long-term prognosis and early curative effect of thrombolysis therapy may be better than anticoagulation therapy.

关 键 词：肺栓塞 抗凝药 溶栓 

分 类 号：R563.5[医药卫生—呼吸系统]