尿激酶及瑞替普酶溶栓治疗肺栓塞的效果分析

赵双锁，王惠霞

（陕西省宝鸡市人民医院呼吸内一科，陕西 宝鸡，721000）

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摘要：

目的 探讨肺栓塞呼吸内科的临床诊治方法，对比尿激酶及瑞替普酶溶栓治疗肺栓塞的效果。方法 以我院呼吸内科2015年9月至2016年8月收治的120例肺栓塞患者为研究对象，随机分成试验组（n=60）与对照组（n=60）。对照组患者行尿激酶溶栓治疗，试验组行瑞替普酶溶栓治疗，对比两组治疗总有效率、临床指标改善情况及患者不良反应发生率。结果 对照组患者治疗总有效率为70.00%（42 例），明显低于试验组的93.33%（56 例）（P<0.05）；治疗后两组患者的RF、HR、PaO₂、PaCO₂、SaO₂ 水平均有改善（P<0.05），试验组患者上述指标均优于对照组（P<0.05）；试验组不良反应总发生率为6.67%（4 例），低于对照组的18.33%（11 例）（P<0.05）。结论 肺栓塞治疗中，瑞替普酶溶栓效果确切且不良反应发生率低，具有临床推广价值。

关键词：肺栓塞；呼吸内科；溶栓；抗凝

中图分类号：R563.5文献标志码：A文章编号：2096-1413(2017)21-0011-02

Clinical effect analysis of urokinase and reteplase in the treatment of pulmonary thromboembolism
ZHAO Shuang-suo, WANG Hui-xia
(the First Department of Respiratory Medicine, the People``s Hospital of Baoji, Baoji 721000, China)

ABSTRACT: Objective To investigate the clinical diagnosis and treatment of pulmonary embolism in respiratory medicine, and compare the effect of urokinase and riputidine thrombolysis in the treatment of pulmonary embolism. Methods One hundred and twenty cases of patients with pulmonary thrombolysis admitted in our hospital from September 2015 to August 2016 were selected, and divided into experimental group (n=60) and control group (n=60) according to random number table method. The experimental group received reteplase treatment, and the control group accepted urokinase thrombolysis treatment, the total effective rate, improvement of related clinical indexes and incidence of adverse reactions were compared between the two groups. Results The total effective rate of the experimental group was 93.33% (56 cases), which was significantly higher than 70.00% (42 cases) of the control group (P<0.05); after treatment, the levels of RF, HR, PaO₂, PaCO₂, SaO₂ in the two groups significantly improved (P<0.05), and above indexes of the experiment group were superior to those of the control group (P<0.05); the total incidence of adverse reactions in the experimental group was 6.67% (4 cases), which was lower than 18.33% (11 cases) in the control group (P<0.05). Conclusion For patients with pulmonary embolism, reteplase has exact effect and lower incidence of adverse reactions, which is worthy of application in clinic.
KEYWORDS: pulmonary embolism; respiratory medicine; thrombolysis; anticoagulant

参考文献：
[1] 张明亮,王爱萍,尹鲁骅,等.急性大面积肺栓塞应用不同剂量瑞替普酶溶栓治疗的血流动力学效果及安全性新增文章[J].心脏杂志,2014,26(5):11.
[2] 冯炜,王一锋,唐榕蔚,等.成人肾病综合征并肺血栓栓塞的临床特征及危险因素分析[J].天津医药,2016,44(3):123.
[3] SHAH KJ,SCILEPPI RM,FRANZ RW,et al.Treatment of pulmonaryembolism using ultrasound-accelerated thrombolysis directly into pulmonary arteries[J].Vasc Endovascul Surg,2011,45(6):541-548.
[4] 王静,赵卉.修正的Geneva 评分、心电图评分联合D-二聚体对肺栓塞的预测价值研究[J].安徽医科大学学报,2017,52(4):78.
[5] 郭伟达.急性肺栓塞心电图特征及在诊断中的作用[J].岭南急诊医学杂志,2016,21(6):112-114.
[6] 郭凤华.16 排螺旋CT 肺血管造影及重建技术在老年人肺动脉栓塞诊断中的临床应用[J].世界最新医学信息文摘,2016,16(73):58.
[7] 王升英,修长顺.尿激酶联合序贯抗凝治疗次大面积肺栓塞疗效分析[J].世界最新医学信息文摘,2016,16(47):67.
[8] 张琳,张言斌,汤春梅,等.拟诊肺结核的肺血栓栓塞症患者的临床特征[J].实用医学杂志,2016,32(22):34.
[9] 宋园园,刘剑波.依达拉奉对肺栓塞患者血清HMGB1、MDA和 LPA水平的影响[J].实用医学杂志,2016,32(22):82.