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目的 评价单纯抗凝与导管内溶栓加抗凝治疗肺动脉栓塞疗效对比。方法 经肺动脉造影或增强螺旋CT证实的急性肺动脉栓塞患者63例, 随机分两组, 一组单纯肝素抗凝32例, 另一组导管内尿激酶溶栓加肝素抗凝31例。结果 单纯抗凝治疗总有效率96 7%; 导管内溶栓加抗凝治疗总有效率100%, 但临床症状改善较快。单纯抗凝无效1例, 经导管内溶栓后好转。经导管内溶栓出现消化道出血1例。本观察无1例死亡。结论 单纯抗凝与导管内溶栓加抗凝治疗总有效率相近, 无并发症出现。所以对无血液动力学改变的急性肺动脉栓塞单纯肝素抗凝即可取得确切疗效, 可降低风险。
Objective To evaluate the curative effect of simple anticoagulation, intraductal thrombolysis plus anticoagulation for pulmonary embolism. Methods Sixty-three patients with acute pulmonary embolism confirmed by pulmonary angiography or enhanced spiral CT were randomly divided into two groups. One group received pure heparin anticoagulation in 32 cases and the other group received intraductal urokinase thrombolysis plus heparin anticoagulation in 31 cases. Results The total effective rate of pure anticoagulant therapy was 96.7%. The total effective rate of intra-catheter thrombolysis plus anticoagulation was 100%, but the clinical symptoms improved rapidly. Simple anticoagulation in 1 case, after transcatheter thrombolysis improved. Transcatheter thrombolysis occurred in 1 case of gastrointestinal bleeding. No one died in this observation. Conclusion Anticoagulant and catheter-assisted thrombolysis plus anticoagulant therapy have the same effective rate and no complications. Therefore, no change in acute hemodynamic changes in acute pulmonary embolism heparin anticoagulation can achieve the exact effect, can reduce the risk.