溶栓治疗急性肺血栓栓塞症的疗效观察

Curative effect observation of thrombolytic therapy on acute pulmonary-thrombo-embolism

目的 研究老年急性肺血栓栓塞症 (PTE)溶栓治疗的疗效和安全性。方法 将住院确诊为急性PTE且年龄大于 6 0岁的 2 6例患者分为尿激酶溶栓加肝素抗凝组 (观察组 )和单纯抗凝组 (对照组 ) ,对比分析治疗前后 2组患者临床表现、血气分析、肺动脉压、螺旋CT或同位素肺灌注通气显像变化。结果 观察组总有效率 (86 % )明显高于对照组 (5 0 % ) (P <0 .0 5 ) ;出血率 (14 % )略高于对照组 (8% ) ,但无显著性差异 ;病死率 (7% )略低于对照组 (17% ) ,但无显著性差异。结论 老年急性PTE溶栓治疗效果明显 ,有一定风险 ,但利大于弊。

Objective It is to study the curative effect and saf ety of thrombolytic therapy on senile acute pulmonary-thrombo-embolism (PTE).Methods 26 patients over 60 years old that were diagnosed as PTE w ere divided in to urokinase thrombolytic therapy plus heparin anticoagulant therapy group (obs ervation group) and only anticoagulant therapy group (control group). The change s of clinical manifestation, blood gas analysis, pulmonary artery pressure, spir al CT or isotope pulmonary perfusion ventilation imagingin the two groups before and after treatment were compared and analyzed.Results The total effective rate in observation group (86%) was ob viously higher than that in control group (50%) (P<0.05). The hemorrhage rate in observati on g roup (14%) was a little higher than that in control group (8%), but there was no significant difference. The case fatality rate in observation group (7%) was a little lower than that in control group (17%), but there was no significant diff erence.Conclusion Thrombolytic therapy on senile acute PTE has evident ef fect, but has some risks. The advantage is better than disadvantage.