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目的探讨急性肺栓塞症的临床特征及治疗效果。方法大流量给氧,待患者缺氧缓解后,调至5L/min持续给氧维持。采用抗凝+溶栓治疗,采用尿激酶(UK)静脉溶栓,按2万U/kg,总量100万U～150万U,加入100ml液体中于2h内滴完,24h后给予抗凝治疗,低分子肝素用量4000u或6000u,每12h皮下注射1次,疗程5～21d,连续应用10d后,改用华法令,根据血栓来源、疾病情况决定华法林用药时间。结果本组30例中显效20例,有效8例,无效2例。结论肺栓塞病死率较高,因此临床上应尽早进行溶栓和抗凝治疗。一经诊断,抗凝与溶栓联合应用。抗凝剂首选低分子肝素钠皮下注射,连续应用10d后,改用华法令,抗凝期参照患者激活部分凝血酶原时间,以维持正常值的2倍左右为宜。溶栓剂应用尿激酶。
Objective To investigate the clinical characteristics and therapeutic effect of acute pulmonary embolism. Methods Large flow to oxygen, to be alleviated in patients with hypoxia, transferred to 5L / min sustained oxygen maintenance. Using anticoagulant + thrombolytic therapy, urokinase (UK) intravenous thrombolysis, according to 20,000 U / kg, the total amount of 1 million U ~ 1.5 million U, 100ml of liquid was added dropwise within 2h End, given anticoagulation after 24h Treatment, the amount of low molecular weight heparin 4000u or 6000u, subcutaneous injection every 12h 1, course of treatment 5 ~ 21d, continuous application of 10d, switch to warfarin, according to the source of thrombosis, warfarin medication time. Results The group of 30 cases markedly effective in 20 cases, effective in 8 cases, 2 cases. Conclusion The mortality of pulmonary embolism is high, therefore, thrombolytic therapy and anticoagulant therapy should be carried out as soon as possible. Once diagnosed, anticoagulant and thrombolytic combination. Anticoagulant preferred low molecular weight heparin sodium subcutaneous injection, continuous application of 10d, switch to warfarin, anticoagulant reference patients activated partial prothrombin time, to maintain the normal value of about 2 times is appropriate. Thrombolytic use of urokinase.