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急性次大面积肺栓塞的溶栓和抗凝治疗

Thrombolytic and anticoagulant therapy for acute submassive pulmonary embolism.

作者信息

Fei Jianwen, Tang Yan, Wu Jinxiang, Kang Lijun, Zhao Jiping, Dai Hong, Bi Wenxiang, Wang Junfei, Liu Fen, Liu Wen, Yang Meng, Dong Liang

机构信息

Department of Pulmonary Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China ; Department of Pulmonary Medicine, Yantai Shan Hospital, Yantai, Shandong 264001, P.R. China.

Department of Pulmonary Medicine, Yantai Shan Hospital, Yantai, Shandong 264001, P.R. China.

出版信息

Exp Ther Med. 2014 Jan;7(1):103-108. doi: 10.3892/etm.2013.1355. Epub 2013 Oct 22.

Abstract

This study aimed to compare the efficacy and safety of thrombolytic and anticoagulant therapy for acute submassive pulmonary embolism (PE). A retrospective evaluation was performed on 25 consecutive inpatients with acute submassive PE treated by thrombolytic therapy and 25 earlier consecutive inpatients with acute submassive PE treated by anticoagulant therapy. No statistically significant difference in clinical curative effect was identified between the thrombolysis and anticoagulation groups (P>0.05). Following 24 h of therapy, the improvement rates of dyspnea and revascularization in the thrombolysis group achieved statistical significance compared with those of the anticoagulation group (P<0.01 for each). The PO level of the thrombolysis group (81.18±5.66 mmHg) was notably higher than that of the anticoagulation group and the difference was statistically significant (P<0.01). The pulmonary arterial pressures of the thrombolysis group (51.21±6.86 mmHg) were significantly lower than those of the anticoagulation group (60.64±5.17 mmHg) (P<0.01). Furthermore, the difference between the hemorrhage rates of the two groups was statistically significant (P<0.05). Thrombolysis was shown to rapidly relieve dyspnea, reduce pulmonary arterial pressure and revascularize the embolized blood vessels. However, the hemorrhage rate of the thrombolysis group was higher than that of the anticoagulation group. The overall efficacies and fatality rates of the thrombolysis and anticoagulation groups were similar.

摘要

本研究旨在比较溶栓和抗凝治疗对急性次大面积肺栓塞(PE)的疗效和安全性。对连续25例接受溶栓治疗的急性次大面积PE住院患者和25例更早接受抗凝治疗的连续急性次大面积PE住院患者进行回顾性评估。溶栓组和抗凝组之间临床疗效无统计学显著差异(P>0.05)。治疗24小时后,溶栓组呼吸困难改善率和血管再通率与抗凝组相比具有统计学显著性(每项P<0.01)。溶栓组的PO水平(81.18±5.66 mmHg)显著高于抗凝组,差异具有统计学显著性(P<0.01)。溶栓组的肺动脉压(51.21±6.86 mmHg)显著低于抗凝组(60.64±5.17 mmHg)(P<0.01)。此外,两组出血率差异具有统计学显著性(P<0.05)。结果显示,溶栓可迅速缓解呼吸困难,降低肺动脉压,并使栓塞血管再通。然而,溶栓组的出血率高于抗凝组。溶栓组和抗凝组的总体疗效和死亡率相似。

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本文引用的文献

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Update on acute pulmonary embolism.
Eur Respir Rev. 2009 Sep;18(113):137-47. doi: 10.1183/09059180.00004609.

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