腔内介入联合利伐沙班对急性肺动脉栓塞患者血气指标与肺功能的影响

Effect of endovascular intervention combined with rivaroxaban on blood gas and pulmonary function in patients with acute pulmonary embolism

目的观察腔内介入联合利伐沙班治疗对急性肺动脉栓塞(PE)患者血气指标与肺功能的影响。方法选择2016年1月—2017年6月哈尔滨医科大学附属第二医院血管外科收治的100例PE患者作为研究对象,按照随机抽样方法分为对照组(n=50)和观察组(n=50)。对照组采用单纯抗凝治疗,观察组采用腔内介入联合利伐沙班治疗。比较2组患者治疗后的总有效率、治疗前后的平均肺动脉压(MPAP)、血气指标[血氧饱和度(SpO_2)、动脉血氧分压(PaO_2)、二氧化碳分压(PaCO_2)]和肺功能指标[第1秒用力呼气容积占预计值百分比(FEV_1%)、第1秒用力呼气量占用力肺活量比值(FEV_1/FVC)、每分钟最大通气量占预计值百分比(MVV%)],并比较2组并发症的发生率。结果与对照组比较,观察组患者总有效率明显升高(98.00%vs. 78.00%,χ~2=12.360,P=0.000);与治疗前比较,治疗后2组MPAP、PaCO_2降低,而SpO_2、PaO_2升高,且观察组变化幅度较对照组更明显(t=3.839、4.753、6.390、10.943,P均=0.000);与治疗前比较,2组治疗后的FEV_1%、FEV_1/FVC、MVV%均升高,且观察组高于对照组(t=5.553、5.910、6.581,P均=0.000);2组患者并发症发生率比较差异无统计学意义(24.00%vs. 14.00%,χ~2=1.624,P=0.202)。结论腔内介入与利伐沙班联合治疗PE患者疗效确切,可明显改善PE患者的血气指标与肺功能,安全可靠,可在PE的临床治疗中推广使用。

Objective To observe the effects of endovascular intervention combined with rivaroxaban on blood gas and pulmonary function in patients with acute pulmonary embolism(PE).Methods One hundred PE patients admitted to the Department of Vascular Surgery of the Second Affiliated Hospital of Harbin Medical University from January 2016 to June 2017 were selected as the subjects.They were randomly divided into control group(n=50)and observation group(n=50).The control group was treated with anticoagulation alone,while the observation group was treated with intracavitary intervention combined with rivaroxaban.The total effective rate,mean pulmonary artery pressure(MPAP),blood gas index(SpO 2,PaO 2,PaCO 2)and lung function index(FEV 1%,FEV 1%,FEV 1/FVC)of the two groups were compared before and after treatment.Maximum ventilation volume as a percentage of predicted value(MVV%)and the incidence of complications were compared between the two groups.Results Compared with the control group,the total effective rate in the observation group increased significantly(98.00%vs.78.00%,χ^2=12.360,P=0.000);MPAP,PaCO2 decreased,SpO2 and PaO2 increased in the two groups after treatment,and the change range in the observation group was more obvious than that in the control group(t=3.839,t=4.753,t=6.390,t=10.943,P=0.000);compared with before treatment,FEV 1%,FEV 1/FVC,MV in the two groups after treatment.The incidence of complications in the observation group was higher than that in the control group(t=5.553,t=5.910,t=6.581,P=0.000).There was no significant difference in the incidence of complications between the two groups(24.00%vs.14.00%,χ^2=1.624,P=0.202).Conclusion Endovascular intervention combined with rivaroxaban is effective in treating PE patients.It can significantly improve blood gas index and lung function of PE patients.It is safe and reliable,and can be widely used in the clinical treatment of PE.