CAJ | 학술논문

目的：中危肺栓塞的治疗方案是采用溶栓治疗还是抗凝治疗，学术界争议较大。该研究拟探讨溶栓与抗凝对中危肺血栓栓塞患者的疗效、安全性及长期预后的影响。方法回顾性分析2008年1月至2013年5月因中危肺血栓栓塞于该院治疗的患者48例，采用溶栓治疗25例，单纯抗凝治疗23例；比较两组患者的疗效、安全性及长期预后。结果溶栓组治疗总体有效率为96．00％，抗凝组总体有效率为60．87％（P ＜0．05）。溶栓组、抗凝组各有1例患者出现大出血事件；溶栓组5例出现小出血事件，抗凝组4例小出血事件（P ＞0．05）。长期随访，溶栓组肺血栓栓塞再发率为4．0％；抗凝组肺血栓栓塞再发率为8．7％（P ＞0．05）。结论针对无溶栓治疗禁忌证的中危肺血栓栓塞患者，尽管溶栓费用较抗凝治疗为高，但其疗效好，且副作用与单纯抗凝治疗类似，安全性良好，宜作为临床首选。
목적：중위폐전새적치료방안시채용용전치료환시항응치료，학술계쟁의교대。해연구의탐토용전여항응대중위폐혈전전새환자적료효、안전성급장기예후적영향。방법회고성분석2008년1월지2013년5월인중위폐혈전전새우해원치료적환자48례，채용용전치료25례，단순항응치료23례；비교량조환자적료효、안전성급장기예후。결과용전조치료총체유효솔위96．00％，항응조총체유효솔위60．87％（P ＜0．05）。용전조、항응조각유1례환자출현대출혈사건；용전조5례출현소출혈사건，항응조4례소출혈사건（P ＞0．05）。장기수방，용전조폐혈전전새재발솔위4．0％；항응조폐혈전전새재발솔위8．7％（P ＞0．05）。결론침대무용전치료금기증적중위폐혈전전새환자，진관용전비용교항응치료위고，단기료효호，차부작용여단순항응치료유사，안전성량호，의작위림상수선。
Objective To compare the effect and prognosis between thrombolytic and anticoagulation therapy in patients with intermedi-ate-risk pulmonary thromboembolism.Methods The short-term and long-term data of 48 consecutive patients with intermediate-risk pulmonary thromboembolism between January 2008 and May 2013 were retrospectively reviewed.Among them,25 patients underwent thrombolysis and 23 patients underwent anticoagulation therapy only.The primary endpoints were efficacy,safety and prognosis.Results The effective rate was significantly higher in patients undergoing thrombolysis than in patients undergoing anticoagulation alone (96.00% vs 60.87%,P <0.05).There were no significant differences in bleeding events (P >0.05)and prognosis(P >0.05)be-tween the two groups.Conclusions Thrombolysis can improve the clinical course of patients who have intermediate-risk pulmonary thromboembolism without contraindication of thrombolysis and do not increase bleeding events.