抗凝药物在急性肺栓塞治疗中的应用进展

Advances in the application of anticoagulants in treatment of acute pulmonary embolism

目的详细探究抗凝药物在急性肺栓塞治疗中的应用效果及疗效。方法选取2015年5月至2016年5月本院收治的60例急性肺栓塞患者作为研究对象,根据随机分配原则,将60例分为对照组30例以及观察组30例。对于对照组患者,采用溶栓治疗措施,对于观察组患者,采用抗凝治疗措施。对两组患者分别给予治疗前后,对两组患者PaO_2指标和PaCO_2指标进行比较,并对两组患者治疗效果进行比较。结果对两组患者实施治疗措施后,观察组患者PaO_2指标PaCO_2指标分别为(80.3±5.9)mmHg和(44.9±3.9)mmHg;对照组患者PaO_2指标PaCO_2指标分别为(74.8±6.8)mmHg和(49.8±5.2)mmHg。观察组患者治疗总有效率为83.3%,对照组患者治疗总有效率为73.3%。组间差异具有统计学意义。结论急性肺栓塞患者凝血纤溶系统功能失衡,而且肺血管内皮受到损伤,可以采用溶栓治疗或者抗凝治疗方法。但是,根据本次研究发现,虽然溶栓治疗法与抗凝治疗法都能够改善患者凝血与纤溶系统失衡问题,但是,抗凝治疗法的疗效更为显著,利于患者预后,值得推广和应用。

Objective To investigate the clinical effect of anticoagulants in the treatment of acute pulmonary embolism. Methods A total of 60 patients with acute pulmonary embolism who were admitted to our hospital from May 2015 to May 2016 were enrolled and randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were given thrombolysis, and those in the observation group were given anticoagulant treatment. Partial pressure of oxygen （Pa02） and partial pressure of carbon dioxide （PaCO2） were compared between the two groups before and after treatment, and the clinical outcome was compared between the two groups. Results After treatment, the observation group had a PaO2 of 80.3±5.9 mmHg and a PaCO2 index of 44.9±3.9 mmHg, and the control group had a PaO2 of 74.8±6.8 mmHg and a PaCO2 index of 49.8±5.2 mmHg. The observation group had a significantly higher overall response rate than the control group （83.3% vs 73.3%, P〈0.05）. Conclusion Patients with acute pulmonary embolism have a functional imbalance in the blood coagulation and fibrinolysis system and endothelial injury in the puhnonary vessels and can be treated with thrombolysis or anticoagulant treatment. As is shown in this study, although both thrombolysis and anticoagulant treatment can improve the imbalance in the blood coagulation and fibrinolysis system, anticoagulant treatment has a better clinical effect and brings benefits to patients＂ prognosis. Therefore, it holds promise for clinical application.