摘要
目的 比较低分子肝素和普通肝素治疗非大面积急性肺血栓栓塞症的疗效、副作用和治疗费用 ,以指导临床抗凝药物的选择。方法 33例非大面积急性肺血栓栓塞症患者随机分为低分子肝素组或普通肝素组 ,在抗凝前、抗凝后 1d、 4d、 7d、 10d、 14d观察氧合指数、血小板计数、D -二聚体、纤维蛋白原、肺核素通气灌注扫描、CT肺动脉造影 ,进行疗效、副作用和治疗费用的对照。结果 抗凝后两组患者氧合指数上升 ,D -二聚体和纤维蛋白原下降、肺核素通气灌注扫描和CT肺动脉造影提示栓塞段数减少 ;组间差异无统计学意义 ;低分子肝素组出血和血小板减少发生率为 5 9% ,普通肝素组出血和血小板减少发生率为12 5 % ;低分子肝素组和普通肝素组的治疗费用分别为 (12 2 9 75± 5 2 9 4 0 )元和 (15 35 70± 6 94 6 0 )元。结论 低分子肝素和普通肝素均为有效的抗凝药物 ,综合副作用和治疗费用考虑 ,低分子肝素更适合于临床。
Objective To compare the efficiency,safety,cost of low-molecular-weight-heparin and unfractionated heparin in treating patients with non-massive acute PTE.Methods Thirty-three patients without massive acute PTE were divided into Low-molecular-weight-heparin(LMWH) and Unfractionated heparin(UH)groups at random.Oxygenation index, D-dimer, fibrinogen,lung ventilation/perfusion (V/Q)scan, computed tomography pulmonary angiography (CTPA)were observed before anticoagulation and1,4,7,10,14 day after anticoagulation.Results In both groups oxygenation index elevated,D-dimer and fibrinogen decreased, lung V/Q and CTPA showed embolizedsegments reduced.The occurrence rate of hemorrhage and thrombocytopenia was 5.9% in LMWH group and 12.5% in UH group. It costed (1229.75±529.40) yuan in LMWH group and (1535.70±694.60) yuan in UH group. Conclusion LMWH and UH are both efficient in treating non-massive acute PTE, but LMWH is safer and lower costed, so LMWH is a better therapeutic agent.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第5期309-311,共3页
Chinese Journal of Emergency Medicine
基金
浙江省卫生厅资助项目 ( 2 0 0 3A0 5 8)
