利伐沙班在急性中危肺血栓栓塞合并下肢深静脉血栓患者治疗中的作用

发布时间：2018-04-17 07:10

  本文选题：利伐沙班 + 华法林　； 参考：《实用医学杂志》2017年22期

【摘要】：目的探讨利伐沙班在急性中危肺血栓栓塞合并下肢深静脉血栓患者治疗中的疗效及安全性。方法回顾性分析2010年1月至2017年3月在湖南省人民医院住院治疗的60例急性中危肺血栓栓塞合并下肢深静脉血栓患者临床资料,依据治疗方式不同进行分组,利伐沙班组30例和对照组(低分子肝素序贯华法林)30例,比较两组临床疗效及安全性。结果超声心动图结果表明利伐沙班组和对照组在治疗后第10、20及30天亚组右心室最大短轴、右心室最大短轴与左心室最大短轴直径比值和肺动脉收缩压值明显降低,左心室最大短轴直径明显增加,但两组组间比较差异均无统计学意义(均P0.05)。NT-proBNP值在利伐沙班组和对照组治疗后第10、20和30天显著降低,PO_2值在治疗后第10、20天明显升高,但两组组间比较差异均无统计学意义(均P0.05)。D-二聚体在对照组和利伐沙班组治疗后10 d明显增高,利伐沙班组更明显,而在治疗后20、30 d降低,利伐沙班组下降更显著(P0.05)。结论利伐沙班治疗急性中危肺血栓栓塞合并下肢深静脉血栓患者临床疗效明显且安全,具有临床实施与推广应用价值。
[Abstract]:Objective to evaluate the efficacy and safety of rivastaban in the treatment of acute moderate pulmonary thromboembolism with deep venous thrombosis of lower extremities.Methods from January 2010 to March 2017, 60 patients with acute moderate risk pulmonary thromboembolism complicated with deep venous thrombosis of lower extremity were analyzed retrospectively.The clinical efficacy and safety of rivastaban group (30 cases) and control group (30 cases of low-molecular-weight heparin sequential warfarin) were compared.Results the results of echocardiography showed that the right ventricular maximal short axis, the ratio of right ventricular maximal short axis to left ventricular maximum short axis diameter and pulmonary systolic pressure were significantly decreased in the subgroup 10 ~ 20 and 30 days after treatment.The maximum short axis diameter of left ventricle increased significantly, but there was no significant difference between the two groups (both P0.05).NT-proBNP values were significantly decreased on the 20th and 30th day after treatment in the rivastaban group and the control group).However, there was no significant difference between the two groups (P0.05. D- dimer was significantly increased 10 days after treatment in the control group and rivastaban group, especially in the rivastaban group, but decreased at 2030 days after treatment, and the decrease in the rivastaban group was more significant than that in the rivastaban group.Conclusion Livashaban is effective and safe in the treatment of patients with acute moderate risk pulmonary thromboembolism and deep vein thrombosis of lower extremity.
【作者单位】： 湖南省人民医院呼吸内科;
【基金】：湖南省中医药管理局基金资助项目(编号:201547)
【分类号】：R543.6;R563.5
，

本文编号：1762586