摘要
目的分析阿替普酶(rt-PA)联合达比加群酯治疗急性大面积肺栓塞患者的临床疗效,及其对患者右心功能、血气指标的影响。方法选取2016年3月—2020年8月在我院诊治的急性大面积肺栓塞患者60例,并采用随机数字表法将其分为观察组(n=30)和对照组(n=30)。两组患者先给予低分子肝素治疗,在此基础上,对照组采用达比加群酯胶囊治疗,观察组在对照组基础上加用注射用rt-PA治疗。比较治疗前后两组患者临床疗效、右心功能及血气指标水平。结果观察组与对照组临床治疗总有效率无显著差异(P>0.05);与治疗前相比,两组患者治疗后右室直径、三尖瓣反流差压及肺泡-动脉血氧分压差(P(A-a)O_(2))水平较治疗前明显降低(P<0.05),且观察组较对照组明显降低(P<0.05);与治疗前相比,两组患者治疗后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))水平较治疗前明显升高(P<0.05),且观察组较对照组明显升高(P<0.05)。结论rt-PA联合达比加群酯治疗急性大面积肺栓塞患者临床疗效显著,可明显改善患者右心功能与血气指标水平。
Objective To analyze the clinical efficacy of the treatment of arteprase(rt-PA)combined with dabigatran etexilate in patients with acute massive pulmonary embolism,and the effect on right heart function and blood gas index of patients.Methods A total of 60 patients with acute massive pulmonary embolism in our hospital from Mar.2016 to Aug.2020 were selected and divided into observation group(n=30)and control group(n=30)by using the random number table method.Both groups were firstly treated with low molecular weight heparin,on this basis,the control group was treated with dabigatran etexilate capsules,and the observation group was treated with rt-PA for injection on the basis of the control group.The clinical efficacy,right heart function index and blood gas index were compared between the two groups before and after treatment.Results There was no significant differences in the total effective rate of the observation group and control group(P>0.05).The right atrial diameter,tricuspid regurgitation pressure difference and the level of alveolar-blood oxygen partial pressure difference(P(A-a)O_(2))of both groups after treatment were obviously decreased in comparison with those before treatment(P<0.05),and the observation group was obviously decreased in comparison with those in the control group(P<0.05);The levels of arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of oxygen(PaCO_(2))of both groups after treatment were obviously increased in comparison with those before treatment(P<0.05),and the observation group was obviously increased in comparison with those in the control group(P<0.05).Conclusion The clinical efficacy of rt-PA combined with dabigatran etexilate in the treatment of patients with acute massive pulmonary embolism is significant,and it can improve the right heart function and the level of blood gas index of patients.
作者
李鹏程
LI Peng-cheng(Zhoukou the First People’s Hospital,Zhoukou,Henan 466700,China)
出处
《医药论坛杂志》
2021年第12期52-54,59,共4页
Journal of Medical Forum
关键词
阿替普酶
达比加群酯
急性大面积肺栓塞
右心功能
血气指标
Arteprase
Dabigatran etexilate
Acute massive pulmonary embolism
Right heart function
Blood gas index
