抗凝药物联合溶栓药物治疗急诊重症肺血栓栓塞的临床效果研究

Clinical Efficacy of Anticoagulant Drugs Combined with Thrombolytic Drugs in Severe Acute Pulmonary Thromboembolism

目的研究抗凝药物联合溶栓药物治疗急诊重症肺血栓栓塞的临床效果。方法回顾性分析某院2016年5月~2017年4月收治的76例重症肺血栓栓塞患者的临床资料,将采取抗凝治疗的患者资料组成对照组(共39例,有效37例,脱落2例),将采取抗凝、溶栓药物联合治疗的患者资料组成观察组(共37例,有效36例,脱落1例)。比较两组临床疗效、不良反应、治疗前后凝血功能等。结果观察组有效率高于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);两组治疗前凝血酶原时间(PT)及纤维蛋白原(FIB)比较,差异无统计学意义(P>0.05);治疗后观察组FIB低于对照组,PT高于对照组,差异有统计学意义(P<0.05)。结论抗凝药物与溶栓药物联合治疗急诊重症肺血栓栓塞效果确切,可快速缓解不良症状、改善凝血功能,延缓疾病自然进展,安全性较高。

OBJECTIVE To study the clinical effect of anticoagulant drugs combined with thrombolytic drugs in the treatment of severe pulmonary thromboembolism in emergency department. METHODS The clinical data of 76 patients with severe pulmonary thromboembolism who were treated in a hospital from May 2016 to April 2017 were retrospectively analyzed. The patients who were treated with anticoagulation were included in the control group （39 cases in total, 37 cases of effective cases, and 2 cases of shedding）. Patients taking anticoagulant and thrombolytic drugs were included in the observation group （ 37 cases in total, 36 cases in effective cases, and 1 case in fall）. The clinical efficacy, adverse reactions, and coagulation function before and after treatment were compared between the two groups. RESULTS The observation group was more effective than the control group （P 〈 0.05 ）, and the hospitalization time was less than the control group （P〈0.05）. The incidence of adverse reactions in the two groups was comparable （P〉0.05） ;There was no significant difference in prothrombin time （PT） and fibrinogen （FIB） between the two groups （P〉0.05）. After treatment, the FIB of the observation group was lower than that of the control group, and the PT was higher than that of the control group. The difference was statistically significant （P 〈 0.05 ）. CONCLUSION The combination of anticoagulant drugs and thrombolysis drugs has a definite effect on severe pulmonary thromboembolism in the emergency department with good safety profile.