Efficacy evaluation of thrombolysis combined with anticoagulant therapy in the treatment of patients with Lower extremity deep vein thrombosis combined with moderate pulmonary embolism
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摘要: 目的 研究尿激酶溶栓联合抗凝在治疗下肢深静脉血栓(DVT)合并次大面积肺栓塞患者中的近期疗效。 方法 选取2012年10月—2015年10月金华市中心医院收治的下肢DVT合并次大面积肺栓塞患者108例,按照随机数表法分为对照组(54例)与观察组(54例),对照组行常规低分子肝素及华法林抗凝处理,观察组在常规抗凝基础上联合尿激酶溶栓处理,观察2组患者治疗后咳嗽、胸痛、呼吸困难缓解情况、双下肢周径差及疗效差异;比较治疗前后患者国际标准化比值(INR)、纤维蛋白原(FIB)、D-二聚体、血小板(PLT)、动脉血氧分压(PO2)及凝血指标PT、APTT、TT等,并进行统计学分析。 结果 治疗后2组患者双下肢周径差治明显小于治疗前(P<0.05);治疗后观察组周径差与对照组比较,差异有统计学意义(P<0.05);观察组下肢DVT疗效总效率(92.59%)明显高于对照组(75.93%)(P<0.05);肺栓塞疗效总有效率观察组高于对照组,差异有统计学意义(P<0.05);2组患者D-二聚体均有所下降,且观察组较对照组下降,差异有统计学意义(P<0.05);在INR、FIB、PLT、PO2比较上2组差异不明显(P>0.05);2组患者治疗后,PT、APTT、TT时间均低于治疗前(P<0.05);观察组PT、APTT、TT时间较对照组下降更为显著,差异有统计学意义(P<0.05)。 结论 尿激酶溶栓联合抗凝治疗下肢血栓合并次大面积肺栓塞患者中的近期疗效显著,值得在临床上推广运用。Abstract: Objective To explore the recent efficacy of Urokinase combined with anticoagulant therapy in the treatment of patients with Lower extremity deep vein thrombosis combined with moderate pulmonary embolism. Methods A total of 108 cases of Lower extremity DVT with moderate pulmonary embolism in our hospital from October 2012 to October 2015 were enrolled and randomly divided into control group(n=54) and observation group(n=54).The control group received low molecular weight heparin and warfarin,while the observation group received additional urokinase thrombolysis treatment.The remission of cough,chest pain and breathing difficulties,leg circumference discrepancy and curative efficacy were observed.The international normalized ratio(INR),fibrinogen(FIB),D-dimer,platelet(PLT),arterial oxygen partial pressure(PO2) and coagulation index PT,APTT and TT before and after the treatment were compared statistically. Results After the treatment,the leg circumference discrepancy in both groups was reduced(P<0.05),and the difference was statistical significant between the two groups(P<0.05).In the observation group,the total effective rate(92.59%) of lower limb DVT was significantly higher than 75.93% in control group(P<0.05).The total effective rate of pulmonary embolism in the observation group was higher than that in the control group,and the difference was significant(P<0.05).D-dimer decreased in both groups,especially in the observation group,the difference was statistical significant between the two groups(P<0.05).There was no significant difference in INR,FIB,PLT and PO2(P>0.05).PT,APTT and TT time decreased obviously in both groups after the treatment(P<0.05),and more obvious in the observation group,the difference between the two groups was significant(P<0.05). Conclusion The recent therapeutic effect of Urokinase combined with anticoagulant in the treatment of lower extremity deep vein thrombosis combined with moderate pulmonary embolism is notable,be worthy of further promotion in clinical practice.
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Key words:
- Lower extremity deep vein thrombosis /
- Pulmonary embolism /
- Urokinase /
- Anticoagulation
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