摘要
目的探讨不同危险因素肺栓塞(PE)患者抗凝治疗3个月的临床疗效。方法对2012~2013年山西医科大学第一医院呼吸科诊治的45例PE患者进行研究,根据其危险因素分为短暂危险因素组(A组)、持续危险因素组(B组)及危险因素未明组(C组),观察各组抗凝治疗3个月的治愈率、治疗前后各临床症状、辅助检查结果,采用配对样本t检验。结果抗凝治疗3个月后A、B、C各组治愈率分别为81.3%、0与14.3%。治疗前后比较,A组呼吸困难(87.5%vs.12.5%)与胸痛(50%vs.6.3%)差异有统计学意义,C组呼吸困难(85.7%vs.14.3%)、咯血(35.7%vs.0)差异有统计学意义(均P<0.05);B组各临床症状差异均无统计学意义(均P>0.05)。治疗前后比较,A组肺动脉收缩压与螺旋CT肺动脉造影(CTPA)差异有统计学意义(均P<0.001),B组CTPA差异有统计学意义,C组肺动脉收缩压与CTPA差异有统计学意义。结论不同危险因素PE患者抗凝治疗3个月疗效不同,除短暂危险因素组疗效显著外,其余各组多数未治愈,应3个月后复查相关检查,根据结果适当延长抗凝疗程。
Objective To investigate the clinical effects of three months’ anticoagulation therapy for pulmonary embolism(PE) caused by different risk factors. Methods Did research towards 45 PE patients who were diagnosed and treated by the pneumology department of First Hospital of Shanxi Medical University from 2012 to 2013. Divided them into three groups, which were transient risk factors group(Group A), continuous risk factors group(Group B) and unknown risk factors group(Group C) according to the risk factors. Observed the cure rate, and the clinical symptoms and auxiliary examination results before and after the three months’ anticoagulation therapy, using the paired sample t test. Results After three months’ anticoagulation therapy, the recovery rates of each group respectively are 81.3%, 0 and 14.3%. By comparing the before and after treatment, the difference of dyspnea(87.5% vs. 12.5%) and chest pain(50% vs. 6.3%) of Group A had the statistic significance, the difference of dyspnea(85.7% vs. 14.3%) and hemoptysis(35.7% vs. 0) of Group C had the statistic significance(all P>0.05), while the difference of all clinical symptoms of Group B had no statistic significance(all P>0.05). By comparing the before and after treatment, the difference between the pulmonary artery systolic pressure and CTPA of Group A had the statistic significance(all P<0.001), the CTPA difference of Group B had the statistic significance and the difference between the pulmonary artery systolic pressure and CTPA of Group C had the statistic significance. Conclusion The curative effects of three months’ anticoagulation therapy for pulmonary embolism(PE) caused by different risk factors are different. Only the transient risk factors group has significant effect and most patients in other groups aren’t cured. They should have recheck three months later to postpone the anticoagulation course appropriately based on relative test results.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第17期2539-2542,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家科技支撑课题<慢性阻塞性肺病及肺动脉高压临床体系建设>资助(2013BAI09B00)
关键词
肺栓塞
危险因素
抗凝
疗效
Pulmonary embolism
Risk factors
Anticoagulation
Clinical evaluation
