摘要
目的:探讨依据肺栓塞严重指数(PESI)评分为中危肺栓塞(PTE)患者抗凝治疗的疗效及安全性。方法:对2010年1月至2015年1月住院抗凝治疗的PESI评分为中度危险患者88例,出院后接受持续3个月以上的华法林治疗,依据出院前情况判断短期疗效,出院后随访至少1年时间,分析随访结束前超声心动图、下肢血管彩超情况,观察出血发生率。结果:88例患者短期疗效,总有效率(治愈、显效及好转)86.4%,PESIⅢ级无死亡病例,PESIⅣ级有1例患者死亡,病死率1.1%。患者出院前与入院时血气分析、心肌损伤标志物对照,pH值差异无统计学意义,PaCO_2、PO_2和SO_2较前上升,TNT及BNP明显下降,差异均有统计学意义(P<0.05)。急性期和随访期间对比,肺动脉收缩压、三尖瓣反流率差异有统计学意义(P<0.05),右心室左右径无明显差别。PTE急性期下肢深静脉血栓,随访期间血栓再通率61.5%,PTE急性期及随访过程中,总体出血率4.6%,所有病例无PTE复发。结论:依据肺栓塞严重指数(PESI)评分为中危肺栓塞(PTE)患者抗凝治疗是安全有效的。
Objective： To discussed efficacy and safety of anticoagulant therapy in patients with intermediate-risk pulmonary thromboembolism（ PTE） on the basis of pulmonary embolism severity index（ PESI）score. Methods： The clinical data of 88 cases of intermediate-risk PTE with anticoagulant therapy in hospital and warfarin treatment for more than 3 months after discharge were analyzed between January 2010 and January2015. The short-term curative effects were judged before leaving hospital. Results of echocardiography,colour doppler ultrasound to lower limb blood vessel and incidence of bleeding before the end of follow-up were observed on the basis of followed up for at least 1 year after discharge time. Results： Among 88 cases of patients,the total effective rate was 86. 4% and mortality 1. 1% with Short-term curative effect evaluation. No statistically significant difference existed in p H of blood gas analysis between Admitted to hospital and before leaving hospital. The value of Pa CO_2,PO_2 and SO_2of before leaving hospital were significantly higher than Admitted to hospital,but TNT and BNP of myocardial injury markers were decreased obviously（ P 0. 05）. Pulmonary artery systolic pressure,tricuspid regurgitation rate were statistically significant between the time of acute phase and follow-up（ P 0. 05）,while right ventricular diameter around was no obvious difference. Rate of recanalization of lower extremity deep vein thrombosis during follow-up process was 61. 5% which was found during PTE acute stage. Hemorrhage rate was 4. 6% during follow-up process and all cases were no recurrence of PTE. Conclusion： Anticoagulant therapy is safe and effective in patients with intermediate-risk pulmonary embolism on the basis of PESI score.
出处
《心肺血管病杂志》
2016年第8期609-612,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
肺栓塞
中危
肺栓塞严重程度指数
抗凝治疗
预后
Acute pulmonary embolism
Intermediate-risk
Pulmonary embolism severity index
Anticoagulation therapy
Prognosis
