非大面积肺栓塞患者抗凝治疗3月疗效评价

发布时间：2018-04-20 14:34

  本文选题：肺栓塞 + 抗凝　； 参考：《山西医科大学》2013年硕士论文

【摘要】：目的 评价肺栓塞(pulmonaryembolism,PE)患者抗凝治疗3月的临床疗效，探讨PE抗凝治疗的疗程。 方法 采用描述性研究的方法对山西医科大学第一医院呼吸科2011年8月至2012年6月收治的住院初诊PE患者进行研究。研究期间共收治65例PE，其中资料完整的32例纳入研究。所有患者符合中华医学会呼吸病学分会2001年制定的《肺血栓栓塞症的诊断与治疗指南》（简称指南）的诊断标准，经核素肺通气/灌注扫描（V/Q）、螺旋CT肺动脉造影(CTPA)中至少一项检查确诊，，根据指南标准划分大面积与非大面PE。观察这些患者经规范化抗凝治疗3月后的临床表现及辅助检查情况，并与发病时的情况进行对比。 结果 32例患者治疗前后呼吸困难分别为84.38%及37.5％，咳嗽为43.75％及6.25％，下肢肿胀为40.63％及9.38%，胸痛为28.13％及3.13%。30例心电图SⅠ、QⅢ和/或TⅢ阳性者治疗前后分别为43.33％及6.67%，非特异性ST-T异常者治疗前后分别为63.33％及20.00％。28例超声心动图检查治疗前后肺动脉高压分别为71.43％及25.00％，右室扩大分别为78.57％及64.29％。30例治疗前后下肢深静脉存在血栓分别为87.50％及26.67％。32例治疗前后CTPA肺动脉内充盈缺损分别为87.50％及21.88％；14例治疗前后V/Q肺灌注缺损分别为71.43％及21.43％。右室扩大治疗前后差异无统计学意义（P0.05）,其余各指标治疗前后差异均有统计学意义（均P0.05）。 结论 经规范化抗凝治疗3个月，PE患者的临床表现及辅助检查显著改善，但CTPA、V/Q和/或DVT多数仍存在异常，故应经过临床评估决策抗凝治疗的疗程。
[Abstract]:Purpose Objective: to evaluate the clinical effect of anticoagulant therapy for 3 months in patients with pulmonary embolism (PE) and to explore the course of PE anticoagulant therapy. Method A descriptive study was conducted on PE patients admitted to the Department of Respiratory in the first Hospital of Shanxi Medical University from August 2011 to June 2012. A total of 65 cases of PEI were treated during the study, of which 32 cases with complete data were included in the study. All patients met the diagnostic criteria of the guidelines for the diagnosis and treatment of Pulmonary Thromboembolism (abbreviated as the guidelines) developed by the Chinese Medical Association Respiratory Society in 2001. The diagnosis was confirmed by at least one examination in radionuclide pulmonary ventilation / perfusion scanning (V / Q) and spiral CT pulmonary arteriography (CTPA). According to the criteria of the guidelines, large and non-large area PEs were divided. The clinical manifestations and adjuvant examination of these patients after 3 months of standardized anticoagulant therapy were observed and compared with those at the time of onset. Result 32 patients with dyspnea were 84.38% and 37.5% before and after treatment, 43.75% and 6.25% with cough, 40.63% and 9.38 with lower limb swelling, 28.13% with chest pain and 3.13.30 cases with positive S 鈪

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