低分子肝素单药抗凝治疗癌症相关急性肺血栓栓塞症疗效和预后分析

发布时间：2019-05-05 16:42

【摘要】：目的探讨低分子肝素长程抗凝治疗癌症相关急性肺血栓栓塞症的疗效和预后。方法将2003年3月—2013年3月就诊于中国医科大学附属第一医院癌症相关急性肺血栓栓塞症患者90例,按接受低分子肝素/华法令序贯抗凝治疗和低分子肝素单药抗凝治疗分成两组(即序贯抗凝组53例,单药抗凝组37例),比较两组患者的临床特征、治疗结果和预后。结果两组患者年龄、性别、体质指数、动脉血氧分压、吸烟率、基础疾病患病率及严重程度和肿瘤类型分布间差异均无统计学意义(P0.05),具有可比性。治疗60 d后单药抗凝组低氧血症的改善优于序贯抗凝组,差异有统计学意义(P0.05)。单药抗凝组的再栓塞率和病死率均低于序贯抗凝组(2.7%比20.8%,8.1%比26.4%),差异有统计学意义(P0.05);血小板减少发生率与序贯抗凝组类似(24.3%比22.6%),出血事件发生率相对较低(18.9%比24.5%),差异均无统计学意义(P0.05)。结论低分子肝素单药抗凝治疗可更加有效治疗癌症相关急性肺血栓栓塞症,改善患者预后。
[Abstract]:Objective to evaluate the efficacy and prognosis of low molecular weight heparin (LMWH) in the treatment of cancer-associated acute pulmonary thromboembolism. Methods from March 2003 to March 2013, 90 patients with acute pulmonary thromboembolism associated with cancer were treated in the first affiliated Hospital of China Medical University. According to low molecular weight heparin / warfarin sequential anticoagulation therapy and low molecular weight heparin single drug anticoagulation therapy, they were divided into two groups: sequential anticoagulation group (n = 53) and single drug anticoagulation group (n = 37). The clinical characteristics, treatment results and prognosis of the two groups were compared. Results there was no significant difference in age, sex, body mass index, arterial oxygen pressure, smoking rate, prevalence and severity of underlying diseases between the two groups (P0.05). After 60 days of treatment, the improvement of hypoxemia in single anticoagulation group was better than that in sequential anticoagulation group, the difference was statistically significant (P0.05). The re-embolization rate and mortality of single-drug anticoagulation group were lower than those of sequential anticoagulation group (2.7% vs 20.8%, 8.1% vs 26.4%), the difference was statistically significant (P0.05). The incidence of thrombocytopenia was similar to that of sequential anticoagulation group (24.3% vs 22.6%), while the incidence of bleeding events was relatively low (18.9% vs 24.5%). There was no significant difference between the two groups (P0.05). Conclusion low molecular weight heparin single drug anticoagulation therapy can be more effective in the treatment of cancer-associated acute pulmonary thromboembolism and improve the prognosis of the patients.
【作者单位】：中国医科大学呼吸疾病研究所附属第一医院呼吸科;
【分类号】：R563.5

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