摘要目的 比较急性肺栓塞溶栓与抗凝治疗的疗效,分析溶栓率的变化趋势.方法 对2001年1月至2009年12月间我院收治的190例肺栓塞患者的临床资料进行回顾性分析,分为溶栓组与抗凝组,进行同期资料之间溶栓率的比较,并分别观察两组的有效率、出血率及复发率.结果 2001-2003年(A)、2004-2006年(B)、2007-2009年(C)三个阶段的溶栓率依次分别为45.7%、31.3%、15.3%,溶栓率逐渐下降,A、B与C之间比较有统计学差异(P值均＜0.05);溶栓组有效率(94.8%)与抗凝组(93.2%)比较差异无统计学意义;溶栓组出血率(10.3%)高于抗凝组(2.3%)(P＜0.05);溶栓组复发率(21.8%)与抗凝组(22.5%)比较差异无统计学意义.结论 肺栓塞溶栓治疗的比例趋于下降,溶栓治疗与抗凝治疗比较,疗效大致相同,不能降低复发率,且并发出血率高,风险大,单纯抗凝治疗安全有效.

abstractsObjective To compare therapeutic efficacy of thrombolysis and anticoagulation in acute pulmonary embolism,and to analyze the trend of thrombolysis rate. Methods The clinical data of 190patients with pulmonary embolism in our hospital were retrospectively analyzed. They were divided into thrombolysis group and anticoagulation group. The thrombolysis rate, effective rate, bleeding rate and recurrence rate were compared between two groups. Results The thrombolysis rates on the three stages 2001-2003 (A), 2004-2006(B), 2007-2009(C)were 45.7%, 31.3 %, 15.3 %, which gradually decreased.There was statistical significance between A,B and C (all P ＜0.05). There was no statistical significance on the effective rate between thrombolysis group (94.8%) and anticoagulation group (93.2%). The bleeding rate in thrombolysis group (10.3 %) was higher than that in anticoagulation group (2.3%) (P＜0.05). There was no statistical significance on the recurrence rate between thrombolysis group (21.8%)and antieoagulation group (22.5 %). Conclusions The proportion of thrombolytic therapy in pulmonary embolism tends to decrease. Compared with anticoagulant therapy, thrombolytic therapy has similar effects, can not reduce the recurrence rate,and has a higher bleeding risk. Anticoagulant therapy is safe and effective.