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目的探讨贝前列腺素钠联合抗凝药物治疗非大面积肺栓塞的治疗效果及其安全性。方法 2013年7月至2014年12月收治非大面积肺栓塞的患者60例,随机分成两组,每组30例。对照组常规予低分子肝素和华法林抗凝治疗;观察组在同样抗凝治疗的同时口服贝前列腺素钠40μg,3次/d。两组患者治疗2周后同时接受动脉血气分析、超声心动图检查、6 min步行试验(6MWT)、肺动脉CT血管造影术(CTA)检查。结果两组总有效率无明显差异(93.33%vs 76.67%,P>0.05)。治疗2周后,观察组、对照组的氧分压(Pa O2)、二氧化碳分压(Pa CO2)、氧饱和度(Sa O2)较治疗前均有改善(P均<0.05);治疗后观察组的Pa O2、Pa CO2、Sa O2及6MWT结果均优于对照组(P<0.05或P<0.01);对照组肺动脉收缩压无明显变化,观察组治疗后明显低于本组治疗前及对照组治疗后(P均<0.01)。两组患者均无内脏出血。结论采用贝前列腺素钠联合抗凝治疗非大面积肺栓塞患者安全、有效。
Objective To investigate the therapeutic effect and safety of beraprost sodium combined with anticoagulant in the treatment of non-large-area pulmonary embolism. Methods From July 2013 to December 2014, 60 patients with non-large-area pulmonary embolism were randomly divided into two groups of 30 patients. Control group routine given low molecular weight heparin and warfarin anticoagulant therapy; observation group in the same anticoagulant therapy oral bergentetate sodium 40μg, 3 times / d. Two groups of patients received arterial blood gas analysis, echocardiography, 6-min walking test (6MWT), and pulmonary artery CT angiography (CTA) simultaneously after 2 weeks of treatment. Results There was no significant difference between the two groups (93.33% vs 76.67%, P> 0.05). After 2 weeks of treatment, the PaO2, PaCO2 and SaO2 in the observation group and the control group were significantly improved compared with those before treatment (all P <0.05) The results of Pa O2, Pa CO2, Sa O2 and 6MWT were superior to those of the control group (P <0.05 or P <0.01). The pulmonary arterial systolic pressure in the control group showed no significant change, After treatment (all P <0.01). Both groups had no visceral hemorrhage. Conclusion Bei prostaglandin combined with anticoagulant therapy in patients with non-large area pulmonary embolism is safe and effective.