低分子肝素治疗癌症相关急性肺血栓栓塞症的疗效

目的评价低分子肝素单药抗凝治疗癌症相关急性肺血栓栓塞症的疗效和预后。方法选择于我院就诊的60例癌症相关急性肺血栓栓塞症患者,分为试验组30例和对照组30例,对照组给予常规华法林抗凝治疗,试验组则采用低分子肝素单药抗凝治疗。观察两组患者动脉血氧分压(Pa O2)改善情况,治疗前后D-二聚体和纤维蛋白原(FIB)改善情况,预后情况。结果两组患者治疗后临床症状均有显著缓解,Pa O2、D-二聚体和纤维蛋白原(FIB)比较(P0.05),且试验组患者的改善情况显著优于对照组患者(P0.05),两组患者的病死率及血小板减少发生率均无显著差异(P0.05),但试验组患者的再栓塞率及出血事件发生率显著低于对照组患者(P0.05)。试验组患者的疾病控制率为96.7%高于对照组患者80.0%(χ2=4.0431,P=0.0444)。结论低分子肝素单药抗凝治疗癌症相关急性肺血栓栓塞症的临床疗效显著,可以有效降低再栓塞发生率及出血风险。

The efficacy and prognosis of low molecular weight heparin in the treatment of cancer associated acute pul-monary thromboembolism

Objective To analyze the efficacy and prognosis of low molecular weight heparin in the treatment of cancer associated acute pulmonary thromboembolism.Methods 60 cases of cancer associated with acute pulmo-nary thromboembolism were selected from our hospital,and they were randomly divided into the experimental group of 30 cases and the control group of 30 cases.The conventional warfarin treatment was given to the control group,while the experimental group was treated with low molecular weight heparin monotherapy.The arterial blood oxygen pressure (PaO2 )and the D-dimer and fibrinogen (FIB)were observed in the two groups.The prognosi were observed.Re-sults The levels of PaO2 ,D-dimer and FIB all improved in the two groups after treatment,and the improvement was more pronounced in the experimental group than in the control group (P <0.05).There was no significant difference in mortality and thrombocytopenia between the two groups (P >0.05).However,the rate of re-bleeding and bleeding in the experimental group were significantly lower than those in the control group(P <0.05).The disease control rate was 96.7% in the experimental group and 80.0% in the control group (P <0.05).Conclusion The clinical effi-cacy of low molecular weight heparin in the treatment of cancer associated acute pulmonary thromboembolism is signif-icant,and it can effectively reduce the incidence of re-embolism and bleeding risk.