罗培,刘冬梅,房建斌,顾小卫,吴明明,张巍,曲晨
LUO Pei,LIU Dongmei,FANG Jianbin,GU Xiaowei,WU Mingming,ZHANG Wei,QU Chen

• 1:如东县人民医院心血管内科
• 2:南京医科大学第二附属医院老年科

摘要(Abstract)：

目的:探讨低分子肝素联合华法林及丹参多酚酸盐治疗中、低危急性肺栓塞患者的临床疗效及安全性。方法:80例中、低危急性肺栓塞患者随机分为研究组和对照组,对照组给予低分子肝素加华法林进行治疗,研究组在对照组基础上给予丹参多酚酸盐进行治疗,比较两组患者治疗的总有效率、呼吸频率、心率、血气分析指标、血凝指标、住院时间、住院费用以及不良反应发生率。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,研究组呼吸频率、心率低于对照组(P<0.05),PaO_2、PaCO_2值明显高于对照组(P<0.05),PT、APTT长于对照组(P<0.05);研究组住院时间及住院费用与对照组相比均明显减少(P<0.05),研究组不良反应发生率与对照组相比差异不具有统计学意义(P>0.05)。结论:采用低分子肝素联合华法林及丹参多酚酸盐对中、低危急性肺栓塞临床疗效较好,可有效改善呼吸循环功能。
Objective: To investigate the safety and efficacy of patients with low or intermediate risk acute pulmonary embolism treated with low molecular weight heparin,warfarin and Salvia miltiorrhiza polyphenols. Methods: 80 cases of patients with low or intermediate risk acute pulmonary embolism were divided into research group and control group; the control group was treated with low molecular weight heparin combined with warfarin,and the research group were treated with Salvia miltiorrhiza polyphenols on the basis of the control group treatment. Total effective rate,respiratory rate,heart rate,blood gas index,blood coagulation index,length of stay,cost of hospitalization,and incidence of adverse reactions of the two groups were compared. Results: The total effective rate of the study group was significantly higher than that of the control group,difference was statistically significant( P <0. 05). The length of stay and cost of hospitalization of the study group were significantly lower than that of the control group( P < 0. 05). The incidence rate of adverse reactions in study group compared with the control group was not significant( P > 0. 05). Conclusion: The use of low molecular weight heparin,warfarin and Salvia miltiorrhiza polyphenols on low or intermediate risk acute pulmonary embolism treatment clinical curative effect is good. It can effectively improve the respiratory function.

关键词(KeyWords)： 肺栓塞;肝素,低分子量;华法林;丹参多酚酸盐;血气分析
acute pulmonary embolism;heparin,low molecular weight;warfarin;Salvia miltiorrhiza polyphenols;blood gas analysis

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金青年项目(81501202)

作者(Author): 罗培,刘冬梅,房建斌,顾小卫,吴明明,张巍,曲晨
LUO Pei,LIU Dongmei,FANG Jianbin,GU Xiaowei,WU Mingming,ZHANG Wei,QU Chen

DOI: 10.19367/j.cnki.1000-2707.2017.01.022

参考文献(References)：

• [1]费建文,唐燕,姜俊杰,等.中老年人创伤后急性次大面积肺栓塞的溶栓和抗凝治疗[J].中华老年医学杂志,2013(7):734-737.
• [2]Schouver ED,Chiche O,Bouvier P,et al.Diuretic treatment versus fluid expansion in acute normotensive pulmonary embolism[J].Archives of Cardiovascular Diseases Supplements,2016(1):113-114.
• [3]Peters S.Confusion with the diagnosis of acute pulmonary embolism and arrhythmogenic right ventricular cardiomyopathy[J].International Journal of Cardiology,2016(203):317-318.
• [4]姜鹏程.溶栓联合抗凝疗法治疗次大面积肺栓塞老年患者的有效性及安全性[J].现代中西医结合杂志,2014(12):1321-1323.
• [5]中华医学会心血管病学分会肺血管病学组,中国医师协会心血管内科医师分会.急性肺血栓栓塞症诊断治疗中国专家共识[J].中华内科杂志,2010(1):74-81.
• [6]Zhang JH,Liu GZ,Wang SF,et al.The electrocardiographic characteristics of an acute embolism in the pulmonary trunk and the main pulmonary arteries[J].The American Journal of Emergency Medicine,2016(2):212-217
• [7]刘汉平.小剂量尿激酶加序贯抗凝治疗次大面积肺栓塞的疗效分析[J].现代诊断与治疗,2012(6):787-788.
• [8]Ostovan MA,Ghaffari S,Pourafkari L,et al.Modification of simplified pulmonary embolism severity index and its prognostic valuein patients with acute pulmonary embolism[J].Heart,Lung and Circulation,2016(2):184-190.
• [9]孙为勤,薛蓉.疏血通注射液联合低分子肝素、华法令治疗肺栓塞的临床观察[J].山西大同大学学报:自然科学版,2015(1):36-38.
• [10]Wangab CY,Ignjatoviccd V,Francise P,et al.Risk factors and clinical features of acute pulmonary embolism in children from the community[J].Thrombosis Research,2016(138):86-90.
• [11]范宏军.低分子肝素治疗急性非大面积肺栓塞的临床观察[J].医学理论与实践,2013(11):1453-1454.
• [12]章永忠,邓红春.低分子肝素钠联合华法林治疗非大面积肺栓塞及呼吸困难的疗效分析[J].航空航天医学杂志,2016(1):21-23.
• [13]曹励强,唐良法,赵洪达.序贯抗凝联合小剂量尿激酶抗凝治疗对次全大面积肺栓塞患者的临床疗效探究[J].中国煤炭工业医学杂志,2014(10):1591-1592.
• [14]陈桂霞.低分子肝素在冠心病介入治疗中的临床应用价值[J].转化医学杂志,2015(6):47-49.
• [15]田志,梅霞,饶英.疏血通注射液治疗肺栓塞临床观察[J].中国中医急症,2014(7):1385-1386.
• [16]王丽,李维琼,王正中,等.急性肺栓塞292例临床分析[J].中华实用诊断与治疗杂志,2013(1):89-90.
• [17]侯晗.尿激酶与瑞替普酶分别联合华法林和低分子肝素治疗高危组急性肺栓塞的临床疗效及对凝血系统的影响[J].临床药理,2015(12):5-8.
• [18]朱妍妍,翟振国.静脉血栓栓塞症抗凝治疗管理策略[J].中国实用内科杂志,2013(5):355-358.
• [19]王昕华,吕蕾,赵弘卿.前列地尔联合瑞替普酶和低分子肝素对急性肺栓塞合并肺动脉高压患者的临床疗效[J].临床急诊杂志,2016(6):474-478.
• [20]卢青,卢志刚.丹参多酚酸盐注射液对老年慢性肺源性心脏病患者IL-4及IFN-γ的影响[J].临床肺科杂志,2014(2):353-354.
• [21]左蕾,董正惠,郭晓枫.丹参多酚酸盐注射液对血流动力学稳定型肺栓塞的疗效[J].新疆医科大学学报,2014(5):610-611.
• [22]阿丽亚·哈力克.丹参多酚酸盐注射液对血流动力学稳定型肺栓塞的疗效[J].世界最新医学信息文摘,2015(54):78-79.

文章评论(Comment)：