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目的探讨溶栓和抗凝治疗对中老年人急性次大面积肺栓塞的有效性。方法收集我院70例次大面积肺栓塞中老年患者资料,将患者随机分为两组,各35例,观察组患者采用溶栓治疗,对照组患者使用抗凝治疗,观察比较两组患者的临床疗效和治疗前后的右心功能变化、血栓再通以及出血情况。结果观察组患者治疗总有效率为94.3%,明显高于对照组的85.7%(P<0.05),观察组患者治疗后的右心功能和血栓再通情况均明显优于对照组(P<0.05),两组患者出血率和病死率比较差异无统计学意义(P>0.05)。结论在治疗中老年急性大面积肺栓塞时,溶栓治疗效果明显优于抗凝治疗,但出血风险较大,因此需要结合患者的具体情况和医生的临床经验选择合适的治疗方法。
Objective To investigate the effectiveness of thrombolytic and anticoagulation therapy in the treatment of acute sub-maxillary pulmonary embolism in the elderly. Methods The data of 70 elderly patients with large pulmonary embolism in our hospital were collected. The patients were randomly divided into two groups of 35 patients. The patients in the observation group were treated with thrombolysis. The patients in the control group were treated with anticoagulant therapy. The patients in the two groups were compared Clinical efficacy and right heart function before and after treatment changes, thrombectomy and bleeding. Results The total effective rate of observation group was 94.3%, which was significantly higher than that of control group (85.7%, P <0.05). Right heart function and thrombus recanalization after treatment in observation group were significantly better than those in control group (P <0.05 ), There was no significant difference between the two groups in bleeding rate and mortality (P> 0.05). Conclusion In the treatment of middle and old acute large area pulmonary embolism, thrombolytic therapy is better than anticoagulant therapy, but the risk of bleeding is larger. Therefore, we need to select the appropriate treatment in combination with the specific conditions of the patients and the clinical experience of the doctor.