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利伐沙班联合阿替普酶治疗急性肺栓塞患者的效果

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目的:观察利伐沙班联合阿替普酶治疗急性肺栓塞患者的效果.方法:回顾性分析2020—2023年该院收治的60例急性肺栓塞患者的临床资料,按照治疗方法不同将其分为对照组和观察组各30例.两组均进行基础治疗,在此基础上,对照组采用华法林联合阿替普酶治疗,观察组采用利伐沙班联合阿替普酶治疗,两组均治疗1个月.比较两组临床疗效,治疗前后血气分析指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、pH值]、凝血功能指标[纤维蛋白原(FIB)、D-二聚体(D-D)]水平,以及不良反应发生率.结果:观察组治疗总有效率为93.33%(28/30),高于对照组的66.67%(20/30),差异有统计学意义(P<0.05);治疗后,两组PaO2水平和pH值均高于治疗前,且观察组高于对照组,两组PaCO2水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组FIB、D-D水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:利伐沙班联合阿替普酶治疗急性肺栓塞患者可提高治疗总有效率,改善血气分析指标水平,降低凝血功能指标水平,效果优于华法林联合阿替普酶治疗.
Effects of Rivaroxaban combined with Alteplase in treatment of patients with acute pulmonary embolism
Objective:To observe effects of Rivaroxaban combined with Alteplase in treatment of patients with acute pulmonary embolism. Methods:The clinical data of 60 patients with acute pulmonary embolism admitted to this hospital from 2020 to 2023 were retrospectively analyzed. According to different treatment methods,they were divided into control group and observation group,30 cases in each group. Both groups received basic treatment. On this basis,the control group was treated with Warfarin combined with Alteplase,while the observation group was treated with Rivaroxaban combined with Alteplase. Both groups were treated for 1 month. The clinical efficacy,the blood gas analysis indexes[arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),pH value]and the coagulation function indexes[fibrinogen (FIB),D-dimer (D-D)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate of the observation group was 93.33% (28/30),which was higher than 66.67% (20/30) of the control group,and the difference was statistically significant (P<0.05). After the treatment,the PaO2 levels and pH values of the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the PaCO2 levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant (P<0.05). After the treatment,the levels of FIB and D-D in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant (P<0.05). However,there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions:Rivaroxaban combined with Alteplase in the treatment of the patients with acute pulmonary embolism can improve the total effective rate of treatment,improve the levels of blood gas analysis indexes,and reduce the levels of coagulation function indexes. Moreover,it is superior to Warfarin combined with Alteplase treatment.

Acute pulmonary embolismRivaroxabanAlteplaseWarfarinBlood gas analysisCoagulation functionAdverse reaction

黄运忠、谢志辉、黄燕婷

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中山大学附属第三医院粤东医院,急诊医学科,广东 梅州 514011

中山大学附属第三医院粤东医院,心血管内科,广东 梅州 514011

梅州市人民医院华城医院内科,广东 梅州 514000

急性肺栓塞 利伐沙班 阿替普酶 华法林 血气分析 凝血功能 不良反应

2024

中国民康医学
中国社会工作协会

中国民康医学

影响因子:0.649
ISSN:1672-0369
年,卷(期):2024.36(23)