低分子量肝素钙联合华法林与利伐沙班治疗肺癌合并急性肺栓塞的效果比较  

Comparison of the effect of warfarin versus rivaroxaban in combined therapy with low-molecular-weight heparin calcium for lung cancer complicated by acute pulmonary embolism

作　　者：韩利娜[1] 王向迎 Han Lina;Wang Xiangying(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学科,洛阳471000

出　　处：《中国实用医刊》2024年第24期97-100,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较低分子量肝素钙联合华法林与利伐沙班治疗肺癌合并急性肺栓塞的疗效。方法队列研究。抽取2021年6月至2023年6月河南科技大学第一附属医院收治的84例肺癌合并急性肺栓塞患者, 按照随机数字表法分为对照组和观察组, 每组42例。两组均采用低分子肝素钙进行抗凝, 在此基础上, 对照组口服华法林, 观察组口服利伐沙班。评估两组临床疗效、凝血功能指标、血气指标、血小板功能及治疗安全性。结果观察组总有效率(90.48%, 38/42)高于对照组(71.43%, 30/42), P<0.05。治疗后, 观察组凝血功能各项指标均优于对照组(P均<0.05)。治疗后, 观察组血气指标改善程度优于对照组(P<0.05)。治疗后, 观察组血小板计数、血小板分布宽度、平均血小板体积均低于对照组(P均<0.05)。观察组不良反应发生率(11.90%, 5/42)与对照组(9.52%, 4/42)比较差异未见统计学意义(P>0.05)。结论与华法林相比较, 利伐沙班联合低分子量肝素钙用于肺癌合并肺栓塞患者治疗效果更好, 能进一步优化患者凝血功能, 提高患者血气指标, 改善患者的血小板参数, 治疗安全性良好。Objective To compare the effect of warfarin versus rivaroxaban in combined therapy with low-molecular-weight heparin calcium for lung cancer complicated by acute pulmonary embolism.MethodsEighty-four patients with lung cancer complicated by acute pulmonary embolism admitted to the First Affiliated Hospital of Henan University of Science and Technology from June 2021 to June 2023 were selected for the cohort study.And they were divided into the control group and the observation group by random number table method,with 42 cases in each group.Both groups were treated with low-molecular-weight heparin calcium for anticoagulation,while patients in the control group took warfarin orally,and patients in the observation group took rivaroxaban orally.The clinical efficacy,coagulation function indexes,blood gas indexes,platelet function,and therapeutic safety of the two groups were evaluated.ResultsThe total effective rate of the observation group(90.48%,38/42)was higher than that of the control group(71.43%,30/42),P<0.05.The indicators of coagulation function in the observation group were better than those in the control group after treatment(all P<0.05).The degree of improvement of blood gas indexes in the observation group was better than that in the control group after treatment(P<0.05).After treatment,platelet count,platelet distribution width,and mean platelet volume of the observation group were lower than those of the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(11.90%,5/42)and the control group(9.52%,4/42),P>0.05.ConclusionsCompared with warfarin combined with low-molecular-weight heparin calcium,rivaroxaban combined with low-molecular-weight heparin calcium has better therapeutic effects on patients with lung cancer complicated by pulmonary embolism,which can further optimize coagulation function,improve blood gas indexes and platelet parameters,with good therapeutic safety.

关 键 词：肺癌 肺栓塞 利伐沙班 华法林 低分子量肝素钙 临床疗效 凝血功能 

分 类 号：R73[医药卫生—肿瘤]