中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
9期
1072-1073
,共2页
肺栓塞%法舒地尔%低分子肝素
肺栓塞%法舒地爾%低分子肝素
폐전새%법서지이%저분자간소
Pulmonary embolism%Fasudil%Low molecular weight heparin
目的 观察法舒地尔联合低分子肝素治疗肺血栓栓塞症的临床疗效.方法 将46例非大面积肺血栓栓塞症患者完全随机分为2组,法舒地尔联合低分子肝素组和普通肝素组各23例.法舒地尔联合低分子肝素组给予低分子肝素钙1 mg/kg皮下注射,1次/12 h,第8天起加用华法林,第11天停用低分子肝素,总疗程3～6个月；同时应用盐酸法舒地尔30 mg+生理盐水100ml静脉滴注,1次/8 h,连续应用14 d.普通肝素组给予普通肝素首剂80 IU/kg静脉注射,然后以18 IU/(kg·h)的剂量静脉泵入,第8天起加用华法林,第11天停用普通肝素.在抗凝过程中,分别观察2组患者血小板、出凝血时间、国际标准化比值(INR)、APTT、D-二聚体、纤维蛋白原、血气分析( ABG)、肺核素通气/灌注扫描(V/Q)、CT肺动脉造影( CTPA)等情况,对2组治疗前和治疗后30 d的结果进行疗效评价.结果 法舒地尔联合低分子肝素组治愈14例,显效7例,好转2例,无无效和恶化患者,总有效率100.0％.普通肝素组治愈9例,显效3例,好转5例,无效5例,恶化1例,总有效率73.9％.2组总有效率差异有统计学意义(P＜0.05).2组均未出现严重出血.结论 法舒地尔联合低分子肝素治疗非大面积肺血栓栓塞症是一种安全、有效的方法.
目的 觀察法舒地爾聯閤低分子肝素治療肺血栓栓塞癥的臨床療效.方法 將46例非大麵積肺血栓栓塞癥患者完全隨機分為2組,法舒地爾聯閤低分子肝素組和普通肝素組各23例.法舒地爾聯閤低分子肝素組給予低分子肝素鈣1 mg/kg皮下註射,1次/12 h,第8天起加用華法林,第11天停用低分子肝素,總療程3～6箇月；同時應用鹽痠法舒地爾30 mg+生理鹽水100ml靜脈滴註,1次/8 h,連續應用14 d.普通肝素組給予普通肝素首劑80 IU/kg靜脈註射,然後以18 IU/(kg·h)的劑量靜脈泵入,第8天起加用華法林,第11天停用普通肝素.在抗凝過程中,分彆觀察2組患者血小闆、齣凝血時間、國際標準化比值(INR)、APTT、D-二聚體、纖維蛋白原、血氣分析( ABG)、肺覈素通氣/灌註掃描(V/Q)、CT肺動脈造影( CTPA)等情況,對2組治療前和治療後30 d的結果進行療效評價.結果 法舒地爾聯閤低分子肝素組治愈14例,顯效7例,好轉2例,無無效和噁化患者,總有效率100.0％.普通肝素組治愈9例,顯效3例,好轉5例,無效5例,噁化1例,總有效率73.9％.2組總有效率差異有統計學意義(P＜0.05).2組均未齣現嚴重齣血.結論 法舒地爾聯閤低分子肝素治療非大麵積肺血栓栓塞癥是一種安全、有效的方法.
목적 관찰법서지이연합저분자간소치료폐혈전전새증적림상료효.방법 장46례비대면적폐혈전전새증환자완전수궤분위2조,법서지이연합저분자간소조화보통간소조각23례.법서지이연합저분자간소조급여저분자간소개1 mg/kg피하주사,1차/12 h,제8천기가용화법림,제11천정용저분자간소,총료정3～6개월；동시응용염산법서지이30 mg+생리염수100ml정맥적주,1차/8 h,련속응용14 d.보통간소조급여보통간소수제80 IU/kg정맥주사,연후이18 IU/(kg·h)적제량정맥빙입,제8천기가용화법림,제11천정용보통간소.재항응과정중,분별관찰2조환자혈소판、출응혈시간、국제표준화비치(INR)、APTT、D-이취체、섬유단백원、혈기분석( ABG)、폐핵소통기/관주소묘(V/Q)、CT폐동맥조영( CTPA)등정황,대2조치료전화치료후30 d적결과진행료효평개.결과 법서지이연합저분자간소조치유14례,현효7례,호전2례,무무효화악화환자,총유효솔100.0％.보통간소조치유9례,현효3례,호전5례,무효5례,악화1례,총유효솔73.9％.2조총유효솔차이유통계학의의(P＜0.05).2조균미출현엄중출혈.결론 법서지이연합저분자간소치료비대면적폐혈전전새증시일충안전、유효적방법.
Objective To observe the clinical efficiency of fasudil combined with low molecular weight heparin in the patients with non-massive acute pulmonary thromboembolism (PTE).Methods Forty-six patients with non-massive acute PTE were randomly divided into two groups:fasudil combined with low molecular weight heparin group and unfractionated heparin group (23 patients of each group).Fasudil combined with low molecular weight heparin group were treated with low molecular heparin calcium 1 mg/kg with warfarin at the eighth day,and stopped low molecular weight heparin at eleventh days with warfarin therapy separately;the total course was 3 to 6 months.At the same time fasudil hydroehloride 30 mg + 100 ml saline infusion was used for 14 d. Unfractionated heparin group were given unfractionated heparin 80 IU/kg intravenous injection,and then to 18 IU/(kg·h)doses,added warfarin at eighth day, unfractionated heparin stopped at eleventh days. Platelet, coagulation time,international normalized ratio (INR),activeated partial thromboplastin time (APTT),D-two dimer,fibrinogen,blood gas analysis (ABG),nuclein lung ventilation/perfusion scan (V/Q)and CT pulmonary angiography (CTPA )of two groups were observed.The curative effect in the two groups before treatment and after treatment of 30 days were evaluated.Results In fasudil combined with low molecular heparin group,14 cases were cured,7 eases were effective and 2 cases were improved.There was no invalid and deterioration of the patients and the total efficiency rate was 100.0％. In unfractionated heparin group,9 cases were cured,3 cases were effective,5 eases were improved,5 cases were invalid and 1 case deteriorated.The total efficiency rate was 73.9％.The total efficiency rate of two groups after the treatment had a significant difference (P＜0.05 ).The two groups did not have severe bleeding.Conclusion Fasudil combined with low weight molecular heparin may be an effective and sate method fortreatment of non-massive PTE.
