CAJ | 학술논문

目的：：观察应用尿激酶治疗老年急性次大面积肺栓塞的临床疗效及安全性。方法：回顾性分析我院2010年2月至2013年5月收治的93例老年急性次大面积肺栓塞患者的临床资料,按照治疗方法不同分为治疗组(尿激酶溶栓)48例,对照组(低分子肝素及华法林抗凝)45例,比较两组患者的临床疗效及不良反应情况。结果：治疗组总有效率为91.7%,对照组总有效率为77．8%,治疗组总有效率明显高于对照组(χ2=8．225,P=0．037),两组基本生命体征及动脉血气分析结果较治疗前均显著改善,且治疗组的氧分压改善幅度显著大于对照组(P<0．05),治疗组右房内径、右室内径、主肺动脉内径、肺动脉收缩压均较治疗前、同期对照组有明显改善(P<0．05),两组患者出血率比较无明显差异(P>0．05),但治疗组28 d病死率明显低于对照组(P<0．05),具有统计学意义。结论：应用尿激酶治疗老年急性次大面积肺栓塞可有效改善右心功能、提高血栓再通率,有助于改善患者预后。
목적：：관찰응용뇨격매치료노년급성차대면적폐전새적림상료효급안전성。방법：회고성분석아원2010년2월지2013년5월수치적93례노년급성차대면적폐전새환자적림상자료,안조치료방법불동분위치료조(뇨격매용전)48례,대조조(저분자간소급화법림항응)45례,비교량조환자적림상료효급불량반응정황。결과：치료조총유효솔위91.7%,대조조총유효솔위77．8%,치료조총유효솔명현고우대조조(χ2=8．225,P=0．037),량조기본생명체정급동맥혈기분석결과교치료전균현저개선,차치료조적양분압개선폭도현저대우대조조(P<0．05),치료조우방내경、우실내경、주폐동맥내경、폐동맥수축압균교치료전、동기대조조유명현개선(P<0．05),량조환자출혈솔비교무명현차이(P>0．05),단치료조28 d병사솔명현저우대조조(P<0．05),구유통계학의의。결론：응용뇨격매치료노년급성차대면적폐전새가유효개선우심공능、제고혈전재통솔,유조우개선환자예후。
Objective:To observe the clinical efficacy and safety in treatment of elderly patients with acute submassive pulmo-nary embolism. Methods:93 elderly patients with acute submassive pulmonary embolism from Feb. 2010 to May 2013 in our hospital were chosen and divided into treatment group ( Urokinase,48 cases) and control group( low molecular weight heparin and warfarin,45 cases),the clinical efficacy and adverse reactions were compared. Results:The total efficacy of treatment group was 91. 7%,higher than 77. 8% in control group (χ2=8. 225,P=0. 037) . Compared with the control group,basic vital signs and arterial blood gas analysis re-sults of two groups had significant differences,the PO2 value of the observation group had more magnitude improvement than the control group (P<0. 05). Compared with before treatment and concurrent control group,the right atrial,right ventricular diameter,main pulmo-nary artery,pulmonary artery systolic pressure of treatment group had significant improvement ( P<0. 05 ) , the bleeding rates of two groups had no significant difference(P>0. 05),but the 28 days mortality of treatment group was lower than control group(P>0. 05). Conclusion:Urokinase in treatment of the acute submassive pulmonary embolism can improve the right ventricular function effectively, increase thrombus recanalization rate and improve the prognosis.