国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2012年
8期
578-581
,共4页
中危肺栓塞%深静脉血栓形成%溶栓%抗凝%肺动脉收缩压%心脏超声
中危肺栓塞%深靜脈血栓形成%溶栓%抗凝%肺動脈收縮壓%心髒超聲
중위폐전새%심정맥혈전형성%용전%항응%폐동맥수축압%심장초성
Intermediate pulmonary thromboembolism%Deep venous thrombosis%Thrombolysis%Anticoagulation%Pulmonary artery systolic pressure%Echocardiography
目的 通过分析急性中危肺血栓栓塞症合并下肢深静脉血栓形成患者的临床资料,分析不同治疗方案的治疗效果,探讨对该类人群合理的治疗方案.方法 采用回顾性研究方法,收集2006年1月至2011年5月于我院连续收治、临床疑诊肺栓塞并经CT肺动脉造影及心脏彩超、下肢血管超声或CT血管造影确诊为急性中危肺栓塞合并下肢深静脉血栓患者的临床资科.根据治疗方案的不同分为单纯抗凝组和溶栓联合抗凝组.结果 73例急性中危肺栓塞合并下肢深静脉血栓患者最主要的危险因素是外伤手术(50.7％),其次是下肢静脉曲张(35.6％)；最常见的临床表现是呼吸困难(95.9％),最常见的体征是双下肢不对称肿胀(79.5％)；治疗前两组患者年龄、性别及临床表现分布差异无统计学意义(P＞0.05)；两组D-二聚体及心超估测肺动脉收缩压(PASP)明显升高,动脉血氧分压(PaO2)明显下降(P＜0.05),但两组之间指标差异无统计学意义(P＞0.05)；治疗后两组D-二聚体及PaO2较治疗前均有明显改善,但溶栓联合抗凝组PASP明显低于单纯抗凝组(P＜0.05).所有患者治疗后未出现重要部位出血.结论 溶栓联合抗凝治疗能够明显改善患者肺动脉收缩压,进而改善患者右心功能和临床症状,疗效显著优于单纯抗凝治疗.
目的 通過分析急性中危肺血栓栓塞癥閤併下肢深靜脈血栓形成患者的臨床資料,分析不同治療方案的治療效果,探討對該類人群閤理的治療方案.方法 採用迴顧性研究方法,收集2006年1月至2011年5月于我院連續收治、臨床疑診肺栓塞併經CT肺動脈造影及心髒綵超、下肢血管超聲或CT血管造影確診為急性中危肺栓塞閤併下肢深靜脈血栓患者的臨床資科.根據治療方案的不同分為單純抗凝組和溶栓聯閤抗凝組.結果 73例急性中危肺栓塞閤併下肢深靜脈血栓患者最主要的危險因素是外傷手術(50.7％),其次是下肢靜脈麯張(35.6％)；最常見的臨床錶現是呼吸睏難(95.9％),最常見的體徵是雙下肢不對稱腫脹(79.5％)；治療前兩組患者年齡、性彆及臨床錶現分佈差異無統計學意義(P＞0.05)；兩組D-二聚體及心超估測肺動脈收縮壓(PASP)明顯升高,動脈血氧分壓(PaO2)明顯下降(P＜0.05),但兩組之間指標差異無統計學意義(P＞0.05)；治療後兩組D-二聚體及PaO2較治療前均有明顯改善,但溶栓聯閤抗凝組PASP明顯低于單純抗凝組(P＜0.05).所有患者治療後未齣現重要部位齣血.結論 溶栓聯閤抗凝治療能夠明顯改善患者肺動脈收縮壓,進而改善患者右心功能和臨床癥狀,療效顯著優于單純抗凝治療.
목적 통과분석급성중위폐혈전전새증합병하지심정맥혈전형성환자적림상자료,분석불동치료방안적치료효과,탐토대해류인군합리적치료방안.방법 채용회고성연구방법,수집2006년1월지2011년5월우아원련속수치、림상의진폐전새병경CT폐동맥조영급심장채초、하지혈관초성혹CT혈관조영학진위급성중위폐전새합병하지심정맥혈전환자적림상자과.근거치료방안적불동분위단순항응조화용전연합항응조.결과 73례급성중위폐전새합병하지심정맥혈전환자최주요적위험인소시외상수술(50.7％),기차시하지정맥곡장(35.6％)；최상견적림상표현시호흡곤난(95.9％),최상견적체정시쌍하지불대칭종창(79.5％)；치료전량조환자년령、성별급림상표현분포차이무통계학의의(P＞0.05)；량조D-이취체급심초고측폐동맥수축압(PASP)명현승고,동맥혈양분압(PaO2)명현하강(P＜0.05),단량조지간지표차이무통계학의의(P＞0.05)；치료후량조D-이취체급PaO2교치료전균유명현개선,단용전연합항응조PASP명현저우단순항응조(P＜0.05).소유환자치료후미출현중요부위출혈.결론 용전연합항응치료능구명현개선환자폐동맥수축압,진이개선환자우심공능화림상증상,료효현저우우단순항응치료.
Objective To evaluate the efficacy of thrombolytic therapy and/or anticoagulantion with low molecular weight heparin in patients with acute intermediate pulmonary thromboembolism (PTE) with deep venous thrombosis (DVT).Methods This article was a retrospective study of 73 patients date from January 2006 to May 2011 with computed tomographic pulmonary angiography and ultrasonic diagnosed acute intermediate PTE+DVT.All the patients with documented acute intermediate PTE+DVT were treated with two different regimens:thrombolysis combined with anticoagulantion therapy in 39cases,pure anticoagulantion therapy in 34 cases.The D-dimer,blood gas analysis,pulmonary artery systolic pressure (PASP) were compared between the two groups.The diagnosis and treatment processes accorded with the guideline.Results The most common risk factor was trauma and surgery (50.7 ％),then varicose vein (35.6 ％ ).Dyspnea was the most common symptom (95.9 ％ ),crura asymmetrically swollen was the most common sign (79.5％).The two groups had no difference in symptoms,sex and age composition (P ＞0.05).The D-dimer and PASP of both groups significantly elevated,while PaO2decreased ( P ＜ 0.05),and the two groups showed no difference ( P ＞ 0.05).After treatment,the thrombolysis plus amicoagulamion group was significantly better than the pure anticoagulantion group ( P ＜0.05).Major bleeding was not documented.Concluslons Thrombolytic therapy combined with low molecular weight heparin is much more effective for acute intermediate PTE+DVT than anticoagulation alone.
