刘彬森

[摘要]目的 研究溶栓联合抗凝治疗急诊重症肺血栓栓塞症的效果。方法 选取2015年1月～2017年1月在我院急诊科进行治疗的60例重症肺血栓栓塞症患者作为研究对象，随机分为对照组和观察组，各30例。对照组单纯实施抗凝治疗，观察组采用溶栓和抗凝治疗。比较两组的临床治疗效果以及凝血功能指标。结果 观察组的临床总有效率为96.67%，高于对照组的76.67%，差异有统计学意义（P<0.05）。观察组治疗后的PT、FIB、APTT水平优于对照组，差异有统计学意义（P<0.05）。结论 重症肺血栓栓塞症患者会出现呼吸困难、胸痛、发热等临床表现，临床尽早采用溶栓和抗凝治疗的效果比单一使用抗凝治疗更好。

[关键词]重症肺血栓栓塞症；急诊；临床特点；治疗效果

[中图分类号] R563.5 [文献标识码] A [文章编号] 1674-4721（2017）08（b）-0040-03

Observation of effect of thrombolysis combined with anticoagulation in the treatment of severe acute pulmonary thromboembolism

LIU Bin-sen

ICU，People′s Hospital of Shangyou County in Jiangxi Province，Shangyou 341200，China

[Abstract]Objective To study the efficacy of thrombolysis combined with anticoagulation in the treatment of severe acute pulmonary thromboembolism.Methods Altogether 60 patients with severe acute pulmonary thromboembolism who were treated in Department of Emergency in our hospital from January 2015 to January 2017 were selected as the object of this research and randomly divided into the control group and the observation group，with 30 cases in each group.Patients in the control group was only given anticoagulant therapy，the observation group was given thrombolysis and anticoagulant therapy.The clinical efficacy and coagulation function index were compared between the two groups.Results The clinical total effective rate of the observation group was 96.67%，which was higher than 76.67% of the control group，with significant difference （P<0.05）.The levels of PT，FIB and APTT in the observation group after treatment was better than that in the control group，with significant difference （P<0.05）.Conclusion Patients with severe pulmonary thromboembolism may suffer from dyspnea，chest pain，fever and other clinical manifestations.The effect of application of combination of thrombolysis and anticoagulant therapy is better than that of single anticoagulation therapy.

[Key words]Severe pulmonary thromboembolism；Emergency；Clinical characteristics；Treatment effect

肺血栓栓塞症（pulmonary thromboembolism）是常见的心血管疾病，是指以各种栓子阻塞肺动脉系统为其发病原因的一组疾病或临床综合征的总称[1]，发病率高且起病急，病情严重且死亡率高。重症肺血栓栓塞症的主要临床和病理生理特征为肺循环和呼吸功能障碍，严重危及患者的生命安全，故应尽早诊断并予以及时的治疗，提高治疗效果以及预后效果。本研究选取我院收治的重症肺血栓栓塞症患者作为研究对象，探讨溶栓联合抗凝治疗急诊重症肺血栓栓塞症的效果，现报道如下。

1资料与方法

1.1一般资料

选取我院2015年1月～2017年1月收治的60例重症肺血栓栓塞症患者，随机分为观察组和对照组，各30例。入选患者的临床症状与《肺血栓栓塞诊断与治疗指南》中有关肺血栓栓塞症的诊断标准相符合，并经CT、核素肺通气/灌注扫描以及肺动脉造影确诊。所有入选患者均知情本次研究目的及内容并自愿签署知情同意书。……