• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

中危急性肺栓塞患者溶栓治疗的安全性及有效性

Safety and efficacy of the thrombolytic therapy in submissive pulmonary thromboembolism

摘要:

目的 通过前瞻性非随机的对照研究,探讨中危组急性肺栓塞患者接受溶栓治疗的安全性及有效性.方法 连续选择首都医科大学附属北京安贞医院急诊重症监护室2005年6月至2012年5月期间明确诊断的中危组急性肺栓塞177例,其中接受溶栓治疗患者102例,抗凝治疗75例,分别对其在接受治疗后2h、24 h、7d的临床症状、客观指标、肺动脉增强CT及肺灌注通气结果进行评价,数据处理采用配对t检验和x2检验进行统计学分析.结果 ①两组患者基础病比较差异无统计学意义(P>0.05),溶栓组出血6例(5.9%),抗凝组1例(1.3%) (P<0.05),均无致命性出血病例发生;②溶栓组患者治疗2h呼吸、心率、血压的变化差异具有统计学意义(P<0.01);治疗24 h肺动脉收缩压及三尖瓣返流速度明显改善(P<0.01);与溶栓组相比,差异具有统计学意义(P<0.01);③溶栓治疗7d后双下肢深静脉超声显示显效率、好转率分别为83%和96.2%;肺血管增强CT及肺灌注/通气显示显效率、好转率分别为66.7%和98%,明显优于抗凝组(P<0.01);④亚组分析结果显示:发病3d内患者溶栓治疗后的显效率明显高于病程3d以上者(P<0.01).结论 ①中危肺栓塞患者接受溶栓治疗是安全的,强调除外新发不典型脑血管意外事件;②溶栓治疗在2h内迅速缓解中危肺栓塞患者的急性症状;③治疗7d血栓负荷变化提示溶栓组显效率优于抗凝组;④溶栓治疗效果取决于病程.

更多
abstracts:

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P > 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P > 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P <0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0% and 96.2% respectively,and those of CTPA and lung perfusion scan were 66.7% and 98% respectively.The efficiency of TT was significantly superior over AT in this respect (P < 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P < 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

More
  • 浏览:193
  • 下载:192

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷