尿激酶、低分子肝素和华法林的不同联合方案治疗肺栓塞的临床研究

目的观察分别联合使用低分子肝素、尿激酶或华法林治疗肺栓塞（PE）的临床疗效和安全性。方法 63例患者随机分为A组、B组和C组各21例,A组联合使用尿激酶、低分子肝素和华法林,B组仅联合使用尿激酶和华法林,C组仅联合使用低分子肝素和华法林。观察3组临床疗效。结果 A组总有效率为90.48%分别高于B组和C组的71.43%和66.67%,差异有统计学意义（P〈0.05）。胸腔内注药24h后3组红细胞计数、血小板计数、纤维蛋白原、凝血酶原时间和凝血酶时间比较差异均无统计学意义（P〉0.05）。3组患者均对肝素和尿激酶治疗耐受良好,无胸痛和畏寒发热发生,均未增加胸腔内出血的发生率。结论联合使用尿激酶、低分子肝素和华法林治疗PE疗效显著,安全性好,值得临床推广应用。

Clinical study of different joint programmes of Urokinase,Low molecular heparin and Warfarin in the treatment of pulmonary embolism

Objective To observe the clinical efficacy and safety of different joint programmes of Urokinase,Low molecular heparin and Warfarin in the treatment of pulmonary embolism（PE）.Methods 63 cases were randomly divided into group A,B and C,21 cases of each.Group A was treated with Urokinase,Low molecular heparin and Warfarin;Group B was treated with Urokinase and Warfarin;Group C was treated with Low molecular heparin and warfarinThe clinical efficacy of 3 groups were observed.Results The total effective rate of group A was 90.48%,which is respectively higher than 71.43% of group B and 66.67% of group C,and the differences were statistically significant（P0.05）.Talking about red blood corpuscle（RBC）,PLT,fibrinogen,prothrombin time,thrombin time 24 hours after intra thoracic mediation,there were no significant differences（P0.05）.Patients of 3 groups had better tolerance,without stethalgia,chill and fever,and none increased the incidence rate of intrathoracic bleeding.Conclusion Treating PE with Urokinase,Low molecular heparin and Warfarin has significant efficacy and good safety,which is worth clinicalpopularization and application.