【摘要】 目的观察低分子肝素（LMWH）联合华法林治疗急性肺栓塞（APE）的临床疗效。方法选取2015年1月—2016年6月滨州市中心医院收治的APE患者60例,随机分为对照组和观察组,每组30例。在常规治疗基础上,对照组患者皮下注射LMWH,观察组患者皮下注射LMWH 2 d后开始口服华法林片;两组患者均视病情缓解情况治疗15³0 d。比较两组患者临床疗效、治疗前后血气分析指标[包括动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）、动脉血氧饱和度（SaO₂）]及治疗期间不良反应发生率。结果观察组患者临床疗效优于对照组（P<0.05）。治疗前两组患者PaO₂、PaCO₂、SaO₂比较,差异无统计学意义（P>0.05）;治疗后观察组患者PaO₂、SaO₂高于对照组,PaCO₂低于对照组（P<0.05）。两组患者治疗期间不良反应发生率比较,差异无统计学意义（P>0.05）。结论 LMWH联合华法林治疗APE的临床疗效确切,可有效改善患者血气分析指标,且安全性较高。更多还原

【Abstract】 Objective To observe the clinical effect of low-molecular-weight heparin（LMWH） combined with warfarin on acute pulmonary embolism. Methods A total of 60 patients with acute pulmonary embolism were selected in the Central Hospital of Binzhou from January 2015 to June 2016,and they were randomly divided into control group and observation group,each of 30 cases. Based on conventional treatment,patients of control group received subcutaneous injection of LMWH,while patients of observation group received extra oral warfarin after 2 days of subcutaneous injection of LMWH; both groups treated for 15 to 30 days according to the disease remission. Clinical effect,blood-gas analysis index（including PaO₂,PaCO₂ and SaO₂） before and after treatment,and incidence of adverse reactions during the treatment were compared between the two groups. Results Clinical effect of observation group was statistically significantly better than that of control group（P < 0. 05）.No statistically significant differences of PaO₂,PaCO₂ or SaO₂ was found between the two groups before the treatment（P >0. 05）; after treatment,PaO₂ and SaO₂ of observation group were statistically significantly higher than those of control group,while PaCO₂ of observation group was statistically significantly lower than that of control group（P < 0. 05）. No statistically significant differences of incidence adverse reactions was found between the two groups during the treatment（P > 0. 05）.Conclusion LMWH combined with warfarin has certain clinical effect in treating patients with acute pulmonary embolism,can effectively adjust the blood-gas analysis index,and is relatively safe.更多还原