华法林联合低分子肝素治疗肺血栓栓塞的临床效果
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摘要
目的探讨华法林联合低分子肝素治疗肺血栓栓塞的临床效果。方法选取2015年6月至2018年6月于我院就诊的104例肺血栓栓塞患者为研究对象,根据用药方案的不同将其分为对照组(52例,常规治疗+低分子肝素)与观察组(52例,常规治疗+低分子肝素+华法林)。比较两组的治疗效果。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组REVD、REVD/LVED、右室直径、三尖瓣反流差压均明显改善,且观察组优于对照组(P<0.05);两组PAP、PaO2、PaCO2、SaO2、RI均明显改善,且观察组优于对照组(P<0.05);两组FIB、PT、CRP、IL-8、TNF-α水平均明显改善,且观察组优于对照组(P<0.05);两组心理领域、躯体功能、社会领域、物质生活状态评分均明显升高,且观察组高于对照组(P<0.05)。结论华法林联合低分子肝素治疗肺血栓栓塞效果显著,可以改善患者的心肺功能、凝血指标及炎性因子水平,提高患者生活质量,值得临床推广与应用。
Objective To investigate the clinical effect of warfarin combined with low molecular weight heparin in the treatment of pulmonary thromboembolism. Methods A total of 104 patients with pulmonary thromboembolism treated in our hospital from June 2015 to June 2018 were selected as the study objects and divided into control group(52 cases, routine treatment+low molecular weight heparin) and observation group(52 cases, routine treatment+low molecular weight heparin+warfarin) according to the different drug treatment plans. The therapeutic effects of the two groups were compared. Results The total effective rate of treatment in the observation group was significantly higher than that of the control group( P < 0.05). After treatment, the REVD, REVD/LVED, right ventricular diameter and tricuspid regurgitation differential pressure of the two groups improved significantly, and those in the observation group were better than the control group(P<0.05); the PAP, PaO2, PaCO2, SaO2 and RI of the two groups improved significantly, and those in the observation group were better than the control group(P<0.05); the levels of FIB, PT, CRP, IL-8, TNF-α of the two groups improved significantly,and those in the observation group were better than the control group(P<0.05); the scores of psychological sphere, physical function, social sphere and material life status increased significantly, and those in the observation group were significantly higher than the control group(P<0.05). Conclusion Warfarin combined with low molecular weight heparin is effective in treating pulmonary thromboembolism. It can improve the levels of cardiopulmonary function, coagulation indexes and inflammatory factors and quality of life of patients, which is worthy of clinical promotion and application.
Objective To investigate the clinical effect of warfarin combined with low molecular weight heparin in the treatment of pulmonary thromboembolism. Methods A total of 104 patients with pulmonary thromboembolism treated in our hospital from June 2015 to June 2018 were selected as the study objects and divided into control group(52 cases, routine treatment+low molecular weight heparin) and observation group(52 cases, routine treatment+low molecular weight heparin+warfarin) according to the different drug treatment plans. The therapeutic effects of the two groups were compared. Results The total effective rate of treatment in the observation group was significantly higher than that of the control group( P < 0.05). After treatment, the REVD, REVD/LVED, right ventricular diameter and tricuspid regurgitation differential pressure of the two groups improved significantly, and those in the observation group were better than the control group(P<0.05); the PAP, PaO2, PaCO2, SaO2 and RI of the two groups improved significantly, and those in the observation group were better than the control group(P<0.05); the levels of FIB, PT, CRP, IL-8, TNF-α of the two groups improved significantly,and those in the observation group were better than the control group(P<0.05); the scores of psychological sphere, physical function, social sphere and material life status increased significantly, and those in the observation group were significantly higher than the control group(P<0.05). Conclusion Warfarin combined with low molecular weight heparin is effective in treating pulmonary thromboembolism. It can improve the levels of cardiopulmonary function, coagulation indexes and inflammatory factors and quality of life of patients, which is worthy of clinical promotion and application.
引文
[1]赵飞燕,肖树芹,崔英.肺血栓栓塞症患者华法林抗凝治疗的知识、态度及行为的调查分析[J].中华治疗杂志,2016,51(12):1451-1455.
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[3]董星琲,李积凤.慢性血栓栓塞性肺动脉高压的诊断与治疗—《肺血栓栓塞症诊治与预防指南》推荐[J].中国医刊,2018,53(10):1085-1087.
[4]邱璇,黄海屏.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效果观察[J].心理医生,2018,24(25):115-116.
[5]孙树申,王茂均,李宝福.肺癌合并肺血栓栓塞抗凝治疗后血浆蛋白C、抗凝血酶及凝血因子Ⅷ活性的变化[J].华北理工大学学报:医学版,2016,18(5):374-376.
[6]顾滔.低分子肝素联合华法林单纯抗凝治疗急性次大面积肺栓塞的疗效观察[J].心理医生,2017,23(6):104-105.
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[8]李毅,冯波,欧勇.低分子肝素治疗癌症相关急性肺血栓栓塞症的疗效[J].现代养生(下半月版),2018,21(8):45-46.
[9]程燕雯,倪吉祥,朱晶,等.低分子肝素治疗癌症相关急性肺血栓栓塞症的疗效[J].临床肺科杂志,2016,21(8):1475-1477.
[10]薛杨,刁明强,吕静,等.低分子肝素联合华法林治疗开胸术后急性肺栓塞的临床分析[J].华西医学,2017,32(1):5-7.
[11]薛兵,何彦侠,杨霁,等.低相对分子质量肝素联合华法林对肺血栓栓塞患者心功能指标、血清指标及疗效的观察[J].血栓与止血学,2018,24(1):67-69.
[12]王帮亚,杨红卫,张强.法舒地尔联合那屈肝素钙治疗肺血栓栓塞症的临床效果分析[J].当代医学,2017,23(12):18-21.
[2]乔子奇,董丽霞.不同时间联用华法林对低分子肝素钙治疗肺栓塞的疗效影响分析[J].中国处方药,2018,16(2):64-65.
[3]董星琲,李积凤.慢性血栓栓塞性肺动脉高压的诊断与治疗—《肺血栓栓塞症诊治与预防指南》推荐[J].中国医刊,2018,53(10):1085-1087.
[4]邱璇,黄海屏.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效果观察[J].心理医生,2018,24(25):115-116.
[5]孙树申,王茂均,李宝福.肺癌合并肺血栓栓塞抗凝治疗后血浆蛋白C、抗凝血酶及凝血因子Ⅷ活性的变化[J].华北理工大学学报:医学版,2016,18(5):374-376.
[6]顾滔.低分子肝素联合华法林单纯抗凝治疗急性次大面积肺栓塞的疗效观察[J].心理医生,2017,23(6):104-105.
[7]席雪琴.华法林、尿激酶和低分子肝素用于肺栓塞患者治疗中的疗效[J].中西医结合心血管病电子杂志,2016,4(27):72.
[8]李毅,冯波,欧勇.低分子肝素治疗癌症相关急性肺血栓栓塞症的疗效[J].现代养生(下半月版),2018,21(8):45-46.
[9]程燕雯,倪吉祥,朱晶,等.低分子肝素治疗癌症相关急性肺血栓栓塞症的疗效[J].临床肺科杂志,2016,21(8):1475-1477.
[10]薛杨,刁明强,吕静,等.低分子肝素联合华法林治疗开胸术后急性肺栓塞的临床分析[J].华西医学,2017,32(1):5-7.
[11]薛兵,何彦侠,杨霁,等.低相对分子质量肝素联合华法林对肺血栓栓塞患者心功能指标、血清指标及疗效的观察[J].血栓与止血学,2018,24(1):67-69.
[12]王帮亚,杨红卫,张强.法舒地尔联合那屈肝素钙治疗肺血栓栓塞症的临床效果分析[J].当代医学,2017,23(12):18-21.