小剂量溶栓联合抗凝治疗急性次大面积肺血管栓塞效果观察

目的探讨小剂量溶栓联合抗凝治疗急性次大面积肺血管栓塞的临床效果。方法选择80例患者，随机分为两组，各40例，对照组使用阿替普酶，观察组则将对照组使用阿替普酶剂量减半进行，另外联合使用低分子肝素，比较两组患者肺动脉收缩压、右室内径及右房内径，并统计治疗期间发生的出血情况。结果观察组治疗后肺动脉收缩压显著低于对照组（P〈0．05），且右室内径及右房内径小于对照组（P〈0．05），观察组发生皮下出血的比率显著低于对照组，且未发生消化道出血和泌尿道出血。结论小剂量溶栓联合抗凝治疗急性次大面积肺血管栓塞能有效提高临床治疗效果，减少出血倾向，值得临床重视。

Low-dose thrombolytic therapy combined with anticoagulant therapy for acute secondary massive pulmonary embolism

Objective To investigate the effect of low-dose thrombolytic therapy combined with anticoagulant therapy for acute secondary massive pulmonary embolism. Methods 80 cases were randomly divided into two groups, each 40 cases,the control group were used alteplase,the observation group were used half dose alteplase jointed low molecular weight heparin, then patients systolic pulmonary artery pressure and right ventricular diameter and right atrial diameter, and treatment occurred during bleeding were compared in the two groups. Results After treatment, pulmonary artery systolic pressure was significantly lower than control group（P 〈 0.05）, the right ventricular diameter and right atrial diameter were less than control group（P 〈 0.05）, subcutaneous hemorrhage occurred in observation group was significantly lower than the rate of control group, and it had no gastrointestinal bleeding and urinary tract bleeding in observation group. Conclusion Low-dose thrombolytic therapy with combined anticoagulant therapyfor acute secondary massive pulmonary embolism can improve clinical outcomes and reduce bleeding tendency, so it is worthy of attention.