血栓通注射液联合华法林、低分子肝素治疗急性肺血栓栓塞症的临床观察

Clinical Observation of Xueshuantong Injection Combined with Low Molecular Weight Heparin and Warfarin on Acute Pulmonary Thromboembolism

目的：观察血栓通注射液联合法华林、低分子肝素治疗急性肺血栓栓塞症（PTE）的临床疗效和安全性。方法：将152例PTE患者随机均分为对照组和试验组。两组患者均予以卧床休息、吸氧等常规治疗。与此同时,对照组患者给予华法林3-5 mg,口服,qd＋低分子肝素7500U,皮下注射,bid;试验组患者在对照组治疗的基础上给予血栓通注射液140 mg加入0.9%氯化钠注射液100 ml中静脉滴注,qd。两组患者疗程均为14d。观察两组患者的临床疗效,治疗前后动脉血酸碱度（pH）、动脉血氧分压[pbt（O2）]、动脉血二氧化碳分压[pbt（CO2）]等肺动脉血气指标,缺损肺动脉栓塞数及改善率,随访两组患者6个月再入院率和病死率,记录不良反应发生情况。结果：试验组患者总有效率、缺损肺动脉栓塞数改善率均显著高于对照组,两组比较差异有统计学意义（P〈0.05）。治疗前两组患者p H、pbt（O2）、pbt（CO2）、缺损肺动脉栓塞数比较,差异均无统计学意义（P〉0.05）;治疗后两组患者p H、缺损肺动脉栓塞数均显著低于同组治疗前,且试验组低于对照组,pbt（O2）、pbt（CO2）均显著高于同组治疗前,且试验组高于对照组,差异均有统计学意义（P〈0.05）。两组患者再入院率、病死率、不良反应发生率比较,差异均无统计学意义（P〉0.05）。结论：血栓通注射液联合华法林、低分子肝素治疗PTE较华法林联合低分子肝素疗效更好,安全性相似。

OBJECTIVE：To observe clinical efficacy and safety of Xueshuantong combined with low molecular weight heparin and warfarin in the treatment of acute pulmonary thromboembolism（PTE）. METHODS：52 PTE patients were randomly divided into experimental group and control group. Both groups received oxygen inhalation and rested in bed,symptomatic treatment was provided for patients. Control group was additionally given warfarin 3-5 mg orally once a day and low molecular heparin 7 500 U hypodermically twice a day. Experimental group was additionally given Xueshuantong injection 140 mg added into 0.9% Sodium chloride injection 100 ml intravenously. Treatment course of 2 groups lasted for 14 d. Clinical efficacies of 2 groups were observed. Pulmonary arterial gas analysis index [serum pH,pbt（O2）,pbt（CO2）] and the improvement rate of pulmonary artery defect were observed before and after treatment. Readmission rate and fatality rate of 2 groups were followed up for 6 months,and ADR were recorded. RESULTS：The total effective rate and the improvement of pulmonary artery defect in experimental group were significantly higher than in control group;there was statistical significance（P〈0.05）. There was no statistical significance in pulmonary arterial gas analysis index and pulmonary artery defect between 2 groups before treatment;there was statistical significance（P〉0.05）.p H and pulmonary artery defect of 2 groups after treatment were significantly lower than before;the experimental group was significantly lower than the control group. pbt（O2）and pbt（CO2）of 2 groups after treatment were significantly higher than before;the experimental group was significantly higher than the control group;there was statistical significance（P〈0.05）. There was no statistical significance in readmission rate,fatality rate and the incidence of ADR between 2 groups（P〉0.05）. CONCLUSIONS：Xueshuantong injection combined with low molecular weight heparin is effective and safe in the treatment of PTE.