摘要
目的 探析局部溶栓联合贝前列素对肺栓塞合并肺动脉高压患者的疗效及出血风险。方法 选择我院2011年4月~2015年4月收治的103例肺栓塞合并肺动脉高压患者作为研究对象,随机数字表法分为观察组(n=52)与对照组(n=51)。对照组采取全身溶栓联合贝前列素进行治疗,观察组采取局部溶栓联合贝前列素进行治疗,比较两组治疗有效率、治疗前后D二聚体(D-D)与一氧化氮(NO)的变化及并发症发生率。结果 观察组治疗总有效率为96.2%(50/52),对照组为84.3%(43/51),观察组明显更高,差异有统计学意义(P〈0.05)。两组治疗前D-D与NO的差异无统计学意义(P〉0.05),治疗后两组的D-D与NO水平均获得改善,组内前后差异均有统计学意义(P〈0.05),同时观察组治疗后的D-D与NO水平均低于对照组,组间差异有统计学意义(P〈0.05),提示观察组D-D与NO指标改善幅度更大。两组并发症均以心率失常、胸腔积液、出血为主,其中观察组为7.6%(4/52),对照组为23.5%(12/51),其中两组心律失常与胸腔积液发生率接近,但观察组出血发生率低于对照组,差异有统计学意义(P〈0.05)。结论 局部溶栓联合贝前列素为肺栓塞合并肺动脉高压患者的有效治疗方案,疗效满意,且安全性高。
Objective To explore the efficacy of local thrombolysis combined pulmonary embolism complicated by pulmonary arterial hypertension and bleeding beraprost in patients with risk. Methods 103 pa- tients with pulmonary embolism complicated by pulmonary arterial hypertension treated in our hospital from A- pril 2011 to April 2015 were selected as the research objects. According to the random number table method, the patients were divided into the observation group (n = 52 )and the control group( n = 51 ). The control group was treated with systemic thrombolysis combined with beraprost, while the observation group was treated with local thrombolysis combined with beraprost. The effective rates, D- dimer ( D- D ) and nitric oxide ( NO ) before and after the treatment and the incidence of complications were compared between the two groups. Results The total effective rate of the observation group [ 96.2% (50/52) ] was significantly higher than that of the con- trol group [ 84. 3 % (43/51 ) ] ( P 〈 0. 05 ). Before treatment, there were no significant differences of D- D and NO between the two groups ( P 〉 0. 05 ). After treatment, the levels of D- D and NO in the two groups were im- proved. The before and after differences within group were statistically significant (P 〈 0. 05 ). Meanwhile, the levels of D- D and NO in the observation group after the treatment were lower than those in the control group ( P 〈 0. 05 ), which indicated that the improvement of D- D and NO in the observation group was more signifi- cant. The main complications of the two groups were arrhythmia, pleural effusion and bleeding. The incidence of complications in the observation group was 7.6% (4/52) while in the control group was 23.5% ( 12/51 ). The incidence rates of arrhythmia and pleural effusion in the two groups were close, but the incidence of bleed- ing in the observation group was lower than that in the control group (P 〈 0. 05 ). Conclusion Local throm- bolysis combined with beraprost is an effective treatment for patients with pulmonary embolism complicated by pulmonary arterial hypertension. The efficacy is satisfying and the safety is higher.
出处
《血栓与止血学》
2016年第3期273-275,共3页
Chinese Journal of Thrombosis and Hemostasis
关键词
肺栓塞
肺动脉高压
局部溶栓
贝前列素
Pulmonary embolism
Pulmonary arterial hypertension
Local thrombolysis
Bera- prost