低相对分子质量肝素与华法令用于老年肺栓塞抗凝的疗效及出血风险
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摘要
目的分析老年肺栓塞抗凝治疗中低相对分子质量肝素与华法令的临床疗效与出血风险性。方法 2015年3月—2018年3月,于新疆军区总医院收治的老年肺栓塞患者中选取98例,随机分为两组,各49例。对照组患者单独采用低相对分子质量肝素进行治疗,观察组患者在对照组基础上加用华法令,治疗时间均为6个月,比较两组患者临床疗效、出血发生情况以及治疗前后aPTT(活化部分凝血活酶时间)、PT(凝血指标凝血酶原时间)。结果观察组治疗总有效率为97.96%,明显高于对照组的79.59%(χ~2=8.295,P<0.05);观察组患者出血发生率为20.41%(10/49),稍高于对照组的18.37%(9/49),差异无统计学意义(χ~2=0.065,P>0.05);观察组治疗后aPTT与PT均高于对照组,组间差异有统计学意义(P<0.05)。结论老年肺栓塞抗凝治疗中低相对分子质量肝素与华法令联合应用效果更加显著,能降低出血风险性,推广价值显著。
Objective To analyze the clinical efficacy and hemorrhagic risk of low molecular weight heparin and warfarin in elderly patients with pulmonary embolism. Methods From March 2015 to March 2018, 98 patients with senile pulmonary embolism admitted to Xinjiang Military Region General Hospital were randomly divided into two groups,49 cases in each group. The control group was treated with low molecular weight heparin alone. Warfarin was added to the observation group for 6 months. The clinical efficacy, bleeding, and aPTT(activated partial thromboplastin time) and PT(coagulation index prothrombin time) were compared between the two groups. Results The total effective rate of the observation group was 97.96%, which was significantly higher than that of the control group(79.59%, χ~2=8.295, P<0.05). The incidence of bleeding in the observation group was 20.41%(10/49), slightly higher than 18.37%(9/49) of the control group(χ~2=0.065,P>0.05); aPTT and PT were higher in the observation group than in the control group, the difference between the groups was statistically significant, P<0.05. Conclusion The combination of low molecular weight heparin and warfarin in elderly patients with pulmonary embolism is more effective, which can reduce the risk of bleeding and promote the value.
Objective To analyze the clinical efficacy and hemorrhagic risk of low molecular weight heparin and warfarin in elderly patients with pulmonary embolism. Methods From March 2015 to March 2018, 98 patients with senile pulmonary embolism admitted to Xinjiang Military Region General Hospital were randomly divided into two groups,49 cases in each group. The control group was treated with low molecular weight heparin alone. Warfarin was added to the observation group for 6 months. The clinical efficacy, bleeding, and aPTT(activated partial thromboplastin time) and PT(coagulation index prothrombin time) were compared between the two groups. Results The total effective rate of the observation group was 97.96%, which was significantly higher than that of the control group(79.59%, χ~2=8.295, P<0.05). The incidence of bleeding in the observation group was 20.41%(10/49), slightly higher than 18.37%(9/49) of the control group(χ~2=0.065,P>0.05); aPTT and PT were higher in the observation group than in the control group, the difference between the groups was statistically significant, P<0.05. Conclusion The combination of low molecular weight heparin and warfarin in elderly patients with pulmonary embolism is more effective, which can reduce the risk of bleeding and promote the value.
引文
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[11]袁武锋,蒋雷,郑素洁.尿激酶溶栓治疗对下肢深静脉血栓合并急性肺栓塞患者凝血功能、D-二聚体、N-末端脑钠肽前体的影响[J].中华全科医学,2017,15(12):2068-2070.
[12]张丽,王莹,于子荞,等.间歇充气加压联合低分子肝素预防静脉血栓栓塞症效果的系统评价和试验序贯分析[J].护理学报,2017,24(10):17-26.
[2]陈丽秀.低分子肝素联合华法林单纯抗凝治疗急性次大面积肺栓塞的临床效果和安全性观察[J].中国药物警戒,2016,13(11):651-654.
[3]沈鹏.华法林联合低分子肝素治疗晚期肺癌急性非大面积肺栓塞的疗效观察[J].现代药物与临床,2016,31(4):431-434.
[4]许坤,赵弘卿,冯金萍,等.低分子肝素钙和利伐沙班联合阿托伐他汀对急性肺栓塞患者相关指标的影响[J].中国药房,2017,28(21):2940-2943.
[5]陶俊,刘澄英.低分子肝素钙联合阿替普酶对老年次大面积急性肺栓塞的疗效及安全性研究[J].宁夏医科大学学报,2017,39(8):967-970.
[6]张蔚卿,章卫国,朱丽,等.医疗失效模式与效应分析对肺栓塞患者院外口服华法令自我管理的影响[J].护理学报,2017,24(8):8-11.
[7]张志斌,席俊峰,蒋占鑫,等.围术期肺功能康复训练联合低分子肝素防治胸外科患者术后急性肺栓塞[J].成都医学院学报,2016,11(3):303-306.
[8]林国钦,林俊敏,吴黎敏,等.早期应用低分子肝素对胸腹腔肿瘤术后肺栓塞的预防效果研究[J].实用心脑肺血管病杂志,2016,24(11):40-43.
[9]何青松,唐婕,杨国成.低分子肝素分别联合阿替普酶、尿激酶治疗老年次大面积急性肺栓塞的疗效比较研究[J].临床急诊杂志,2016,15(5):388-392.
[10]陈冬丽,谢召峰,汪显祺.阿替普酶溶栓后序贯低分子肝素治疗老年急性次大面积肺栓塞[J].临床误诊误治,2017,30(6):70-74.
[11]袁武锋,蒋雷,郑素洁.尿激酶溶栓治疗对下肢深静脉血栓合并急性肺栓塞患者凝血功能、D-二聚体、N-末端脑钠肽前体的影响[J].中华全科医学,2017,15(12):2068-2070.
[12]张丽,王莹,于子荞,等.间歇充气加压联合低分子肝素预防静脉血栓栓塞症效果的系统评价和试验序贯分析[J].护理学报,2017,24(10):17-26.