利伐沙班治疗肺栓塞20例临床疗效观察(1)
【摘要】 目的 研究肺栓塞(PE)患者应用利伐沙班治疗的临床效果。方法 40例PE患者， 根据治疗方法分为观察组与对照组， 各20例。观察组采用利伐沙班治疗， 对照组采用低分子肝素钙治疗， 比较两组临床疗效。结果 观察组总有效率为95.0%， 明显高于对照组75.0%(P<0.05)；治疗后两组呼吸频率(RR)、心率(HR)、动脉血氧分压(PaO2)以及二氧化碳分压(PaCO2)均较治疗前明显改善(P<0.05)， 且观察组明显优于对照组(P<0.05)；治疗后两组的血D-二聚体(D-D)水平均明显降低(P<0.05)， 且观察组明显低于对照组(P<0.05)；观察组出血反应明显少于对照组(P<0.05)。结论 PE应用利伐沙班治疗效果显著， 能够有效改善临床症状且出血反应较少， 具有较为广阔的应用前景。但本研究样本数较小， 关于其确切效果与安全性还有待进一步大样本研究证实。
【关键词】 肺栓塞；利伐沙班；临床疗效
DOI：10.14163/j.cnki.11-5547/r.2016.29.010
Observation of curative effect by rivaroxaban in the treatment of 20 pulmonary embolism cases ZHANG Chun-lai， HUANG Yan-ming， LIANG Li-ping. Jiangmen City Central Hospital， Jiangmen 529000， China
【Abstract】 Objective To research clinical effect by rivaroxaban in the treatment of pulmonary embolism (PE) patients. Methods A total of 40 PE patients were divided by treatment measures into observation group and control group， with 20 cases in each group. The observation group received rivaroxaban for treatment， while the control group received low-molecular-weight heparin calcium. Clinical effects were compared between the two groups. Results The observation group had obviously higher total effective rate as 95.0% than 75.0% of the control group (P<0.05). After treatment， both groups had much better respiratory rate (RR)， heart rate (HR)， arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) than those before treatment (P<0.05)， and the observation group had much better indexes than the control group (P<0.05). Both groups had remarkably decreased D-dimer (DD) levels after treatment (P<0.05)， and the observation group had much lower level than the control group (P<0.05). The observation group had much fewer hemorrhage reaction than the control group (P<0.05). Conclusion Implement of PE provides excellent effect in treating PE. This method can effectively improve clinical symptoms， along with few hemorrhage reaction and bright application prospect. While study on large sample is still necessary， due to small sample in this research， to guarantee practical effect and safety.
【Key words】 Pulmonary embolism； Rivaroxaban； Clinical effect
PE是一种因外源性或内源性血栓形成， 导致肺动脉和(或)其分支阻塞， 诱发肺动脉循环障碍而致临床病理综合征[1]。抗凝是临床治疗PE的主要方法， 既往多采用低分子肝素钠与华法林钠等对本病进行抗凝治疗， 但副作用较多， 部分患者往往难以耐受。近年来， 随着新型抗凝制剂利伐沙班的应用， PE的临床治疗有效性与安全性得以显著提高。本研究对20例PE患者应用利伐沙班治疗， 现报告如下。
1 资料与方法
1. 1 一般资料 选取2013年1月～2015年12月本院40例PE患者作为研究对象， 根据治疗方法分为观察组与对照组， 各20例。患者均符合PE临床诊断标准[2]， 均经CT肺动脉造影检查确诊， 除外合并严重基础疾病、其他肺部疾病与抗凝药物禁忌证者。观察组中男11例， 女9例， 年龄45～80岁， 平均年龄(53.62±12.16)岁；临床症状：10例呼吸困难， 7例咯血， 12例胸痛， 2例晕厥， 其中， 5例典型三联征(咯血、胸痛、呼吸困难)。对照组中男12例， 女8例， 年龄41～76岁， 平均年龄(52.48±12.35)岁；临床症状：9例呼吸困难， 8例咯血， 15例胸痛， 3例晕厥， 其中， 6例典型三联征(咯血、胸痛、呼吸困难)。两组患者一般资料比较差异无统计学意义(P>0.05)， 具有可比性。, 百拇医药(张春来 黄炎明 梁丽萍)
【关键词】 肺栓塞；利伐沙班；临床疗效
DOI：10.14163/j.cnki.11-5547/r.2016.29.010
Observation of curative effect by rivaroxaban in the treatment of 20 pulmonary embolism cases ZHANG Chun-lai， HUANG Yan-ming， LIANG Li-ping. Jiangmen City Central Hospital， Jiangmen 529000， China
【Abstract】 Objective To research clinical effect by rivaroxaban in the treatment of pulmonary embolism (PE) patients. Methods A total of 40 PE patients were divided by treatment measures into observation group and control group， with 20 cases in each group. The observation group received rivaroxaban for treatment， while the control group received low-molecular-weight heparin calcium. Clinical effects were compared between the two groups. Results The observation group had obviously higher total effective rate as 95.0% than 75.0% of the control group (P<0.05). After treatment， both groups had much better respiratory rate (RR)， heart rate (HR)， arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) than those before treatment (P<0.05)， and the observation group had much better indexes than the control group (P<0.05). Both groups had remarkably decreased D-dimer (DD) levels after treatment (P<0.05)， and the observation group had much lower level than the control group (P<0.05). The observation group had much fewer hemorrhage reaction than the control group (P<0.05). Conclusion Implement of PE provides excellent effect in treating PE. This method can effectively improve clinical symptoms， along with few hemorrhage reaction and bright application prospect. While study on large sample is still necessary， due to small sample in this research， to guarantee practical effect and safety.
【Key words】 Pulmonary embolism； Rivaroxaban； Clinical effect
PE是一种因外源性或内源性血栓形成， 导致肺动脉和(或)其分支阻塞， 诱发肺动脉循环障碍而致临床病理综合征[1]。抗凝是临床治疗PE的主要方法， 既往多采用低分子肝素钠与华法林钠等对本病进行抗凝治疗， 但副作用较多， 部分患者往往难以耐受。近年来， 随着新型抗凝制剂利伐沙班的应用， PE的临床治疗有效性与安全性得以显著提高。本研究对20例PE患者应用利伐沙班治疗， 现报告如下。
1 资料与方法
1. 1 一般资料 选取2013年1月～2015年12月本院40例PE患者作为研究对象， 根据治疗方法分为观察组与对照组， 各20例。患者均符合PE临床诊断标准[2]， 均经CT肺动脉造影检查确诊， 除外合并严重基础疾病、其他肺部疾病与抗凝药物禁忌证者。观察组中男11例， 女9例， 年龄45～80岁， 平均年龄(53.62±12.16)岁；临床症状：10例呼吸困难， 7例咯血， 12例胸痛， 2例晕厥， 其中， 5例典型三联征(咯血、胸痛、呼吸困难)。对照组中男12例， 女8例， 年龄41～76岁， 平均年龄(52.48±12.35)岁；临床症状：9例呼吸困难， 8例咯血， 15例胸痛， 3例晕厥， 其中， 6例典型三联征(咯血、胸痛、呼吸困难)。两组患者一般资料比较差异无统计学意义(P>0.05)， 具有可比性。, 百拇医药(张春来 黄炎明 梁丽萍)