摘要
目的探讨瑞替普酶对高危急性肺血栓栓塞症患者溶栓治疗的效果及出血风险。方法回顾性选取2016年7月—2023年3月山东省济南市章丘区人民医院收治的59例高危肺血栓栓塞症患者的临床资料,采用随机数表法将其分为两组:研究组31例,对照组28例。研究组给予瑞替普酶18 mg溶于生理盐水100 mL,持续静滴约30 min。对照组给予瑞替普酶18 mg以生理盐水稀释后静脉注射,时间不短于2 min,30 min后重复一次。观察两组患者溶栓治疗的临床效果及出血风险。结果溶栓后,两组患者生命体征均有了明显好转,呼吸频率减慢,心率降低,血压较溶栓前趋于稳定,血氧饱和度明显上升,且右心室内径缩小、平均肺动脉压降低、动脉血氧分压明显上升,各项指标前后对比,差异有统计学意义(P<0.05);但两组患者各项指标比较,差异无统计学意义(P>0.05)。研究组出血并发症发生率为12.90%明显低于对照组的35.71%,差异有统计学意义(χ^(2)=4.230,P<0.05)。结论瑞替普酶溶栓治疗高危急性肺栓塞患者取得了令人满意的临床效果,而不同用量和用药方式可降低出血风险。
Objective To investigate the efficacy and bleeding risk of thrombolytic therapy with reteplase in patients with high-risk acute pulmonary thromboembolism.Methods The clinical data of 59 patients with high-risk pulmonary thromboembolism admitted to Zhangqiu District People's Hospital of Jinan City,Shandong Province from July 2016 to March 2023 were selected retrospectively.They were divided into two groups according to the random number table method:31 cases in the study group and 28 cases in the control group.The study group was given reteplase 18 mg dis⁃solved in 100 mL of normal saline,continuous intravenous drip for about 30 min.In the control group,reteplase 18 mg diluted in normal saline was injected intravenously for no less than 2 min,and repeated 30 min later.The clinical ef⁃fect of thrombolytic therapy and bleeding risk in the two groups were observed.Results After thrombolysis,the vital signs of the two groups of patients were significantly improved,respiratory rate slowed down,heart rate decreased,blood pressure tended to be stable compared with before thrombolysis,blood oxygen saturation increased significantly,and the right ventricular diameter decreased,mean pulmonary artery pressure decreased,arterial oxygen partial pres⁃sure increased significantly,the differences before and after the indicators were statistically significant(P<0.05).But there was no statistically significant difference each index between the two groups(P>0.05).The incidence of bleeding adverse reactions in the study group was 12.90%,which was significantly lower than 35.71%in the control group,and the difference was statistically significant(χ^(2)=4.230,P<0.05).Conclusion Reteplase thrombolytic therapy for high-risk acute pulmonary embolism patients achieved satisfactory clinical results,while different dosage and dosing methodscan reduce the risk of bleeding.
作者
王胜和
张萍
刁学芝
袁翠翠
张芳
WANG Shenghe;ZHANG Ping;DIAO Xuezhi;YUAN Cuicui;ZHANG Fang(Department of Cardiology,Jinan Zhangqiu District People's Hospital,Jinan,Shandong Province,250200 China)
出处
《中外医疗》
2023年第29期123-125,138,共4页
China & Foreign Medical Treatment
关键词
高危急性肺栓塞
瑞替普酶
溶栓
High-risk acute pulmonary embolism
Reteplase
Thrombolysis
