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目的评价瑞替普酶(rPA)给药方法在治疗急性下肢深静脉血栓中的临床有效性及安全性。方法将187例急性下肢深静脉血栓形成(ADVT)患者随机分为2组,其中静脉快速滴注rPA溶栓组85例,24 h静脉泵入维持rPA溶栓组102例。通过对其治疗效果进行分析,比较两组患者治疗前后健患肢大、小腿消肿效果,溶栓效果,溶栓效率及溶栓期间并发症。结果两组患者治疗前后健患肢大、小腿消肿及溶栓效果比较差异均无统计学意义(P均>0.05);24 h静脉泵入组患者溶栓时间[(4.76±1.56)d]少于静脉快速滴注组溶栓时间[(6.56±0.83)d],即24 h静脉泵入组溶栓效率高于静脉快速滴注组患者(P<0.05);24 h静脉泵入组患者溶栓期间并发症发生率(3.9%)明显少于静脉快速滴注组(17.6%)(P<0.05)。结论 rPA为治疗ADVT疗效好、起效迅速的溶栓药物,经静脉溶栓效果好,但24 h静脉泵入较静脉快速滴注起效更为迅速,且更为安全。
Objective To evaluate the clinical efficacy and safety of reteplase (rPA) in the treatment of acute deep venous thrombosis of lower extremities. Methods A total of 187 patients with acute lower extremity deep vein thrombosis (ADVT) were randomly divided into two groups: 85 in the intravenous infusion group and 102 in the rPA group. Through the analysis of the treatment effect, compare the two groups of patients before and after treatment of health limbs, calf swelling, thrombolytic effect, thrombolytic efficiency and complications during thrombolysis. Results There was no significant difference between the two groups before and after treatment in patients with healthy limbs, swelling of lower calves and thrombolysis effect (all P> 0.05). The duration of thrombolysis in 24 h intravenous infusion group was (4.76 ± 1.56) days (6.56 ± 0.83) d], that is, the efficiency of thrombolysis in 24-h intravenous infusion group was higher than that of intravenous bolus infusion group (P <0.05); in 24-h intravenous infusion group, The incidence of complications during thrombolysis (3.9%) was significantly less than that of intravenous drip infusion (17.6%) (P <0.05). Conclusions rPA is a thrombolytic agent with good curative effect and rapid onset of action for ADVT. The intravenous thrombolytic effect of rPA is good. However, rapid intravenous infusion of 24-h intravenous infusion is more effective and safer.