急性肺动脉血栓栓塞症临床治疗分析

Clinical analysis on the treatment of acute pulmonary embolism

目的探讨急性肺动脉血栓栓塞临床治疗。方法本研究选取40例急性肺动脉血栓栓塞症的患者作研究对象，均为我院2010年2月～2013年3月收治，依据病情分别采用抗凝治疗及溶栓联合抗凝治疗，比较治疗前后相关指标变化情况，并记录预后。结果无溶栓禁忌，且急性肺动脉血栓栓塞为大面积及次大面积的患者12例，行溶栓联合抗凝治疗，为100％有效率。针对无抗凝禁忌证，非大面积急性肺动脉血栓栓塞症的患者及有溶栓禁忌证大面积或次大面积栓塞者28例行抗凝治疗，有效率为96．4％。治疗后与治疗前比较动脉血氧饱和度、动脉血氧压明显改善，差异有统计学意义（P〈0．05）。结论急性肺动脉血栓栓塞症临床表现多样，需明确诊断，依据病情行针对方案治疗，积极抗凝及溶栓，可提高治疗效果，保障患者生命安全。

Objective To investigate the clinical treatment of acute pulmonary embolism （APE）. Methods A total of 40 patients with APE as study objects,were treated with anticoagulation and thrombolysis combined with anticoagulant therapy respectively according to the illness, in our hospital from February 2010 to March 2013.The changes of the related index were compared before and after treatment and the prognosis was recorded. Results No thrombolysis taboo,and there were massive and submassive PE in 12 cases of patients with APE,by thrombolytic and anticoagulant therapy,with 100% efficiency.Without anticoagulant contraindications,patients with non-massive APE,and massive and submassive PE in 28 cases with thrombolytic contraindications were treated by anticoagulant therapy,with 96.4% efficiency.The arterial oxygen saturation were compared before and after treatment,and arterial oxygen pressure improved significantly,there was statistically significant difference （P 〈 0.05）. Conclusion Various clinical manifestations of APE need to be confirmed and treated individualized according to the illness,with active anticoagulant and thrombolysis therapeutic method,can improve the treatment effect and protect the safety of patients.