小剂量rt-PA溶栓治疗急性肺栓塞效果观察

目的观察小剂量重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗急性肺栓塞的疗效和安全性。方法选择急性肺栓塞患者84例,将其随机分为rt-PA组28例、UK组27例及对照组29例,rt-PA组采用小剂量rt-PA联合抗凝治疗,UK组采用尿激酶(UK)联合抗凝治疗,对照组单纯采用抗凝治疗,比较三组疗效、住院时间及不良反应及死亡情况。结果①rt-PA组治疗有效率为92.86%,与UK组的92.59%比较,差异无统计学意义(P0.05);两组与对照组比较,有效率均明显增高(P0.05)。rt-PA组与UK组住院时间比较(P0.05);与对照组比较,rt-PA组与UK组住院时间均明显缩短,差异有统计学意义(P0.05)。②三组不良反应比较,UK组发生不良反应较rt-PA组及对照组明显增多,差异有统计学意义(P0.05)。rt-PA组与UK组死亡率明显低于对照组(P0.05)。结论小剂量rt-PA治疗急性肺栓塞安全有效。

Effect of small dose of rt-PA in the treatment of acute pulmonary embolism

Objective To observe the curative effect and safety of small dose of recombinant tissue type plasminogen activator （ rt-PA） in the treatment of acute pulmonary embolism. Methods 84 patients with acute pul-monary embolism were randomly divided into the rt-PA group （n=28）, the UK group （n=27） and the control group＆amp;nbsp;（n=29）. The rt-PA group was treated with low dose of rt-PA combined with anticoagulation, the UK group was trea-ted with urokinase （ UK） combined with anticoagulant, and the control group was only treated with anticoagulant ther-apy. Their curative effect, duration of hospital stay, adverse reactions and mortality were compared among the three groups. Results The effective rate was 92. 86% in the rt-PA group, and 92. 59% in the UK group （P〉0. 05）, but it was obviously lower in the control group （ P〈0. 05 ） . There was no significant difference between the rt-PA group and the UK group in duration of hospital stay （ P〉0. 05 ） , but it was significantly longer in the control group （P〈0. 05）. The incidence of adverse reactions was the lowest in the UK group, followed by the rt-PA group and the control group （P〈0. 05）. The mortality was significantly lower in the rt-PA group and the UK group than in the con-trol group （P〈0. 05）. Conclusion Low dose rt-PA is effective and safe in the treatment of acute pulmonary embol-ism.