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目的探讨普通肝素与低分子肝素(LMWH)治疗非大面积肺栓塞的效果、不良反应及费用等。方法将32例确诊的非大面积肺栓塞患者随机分为治疗组和对照组各16例,治疗组给予低分子肝素钠抗凝治疗,100U.kg-1,SC,b id;3 d后加用华法林3 mg.d-1,po,调整至2~3 mg.d-1,稳定2 d后停用LMWH。对照组给予普通肝素抗凝治疗,80 mg.kg-1静脉注射后,根据体重18 U.kg-1静脉泵入,部分活化凝血功能达到1.5~2.5倍,稳定2 d后加用华法林至3 mg.kg-1,调整华法林至2~3 mg.kg-1,稳定2 d后停用肝素。观察两组疗效、不良反应、住院时间及费用。结果LMWH在治疗非大面积肺栓塞过程中在控制症状及效果方面与普通肝素无明显差异,而不良反应、住院经费、住院时间方面明显优于普通肝素。结论使用LMWH治疗非大面积肺栓塞较普通肝素有相应的疗效,且不良反应更少,费用低廉,值得临床推广。
Objective To investigate the effects of unfractionated heparin and low molecular weight heparin (LMWH) on non-large-area pulmonary embolism, adverse reactions and costs. Methods Thirty-two patients with non-maximal pulmonary embolism were randomly divided into treatment group (16 cases) and control group (16 cases). The treatment group was given low molecular weight heparin anticoagulation therapy, 100U.kg-1, SC, Warfarin 3 mg.d-1, po, adjusted to 2 ~ 3 mg.d-1, stable 2 d after the disabled LMWH. The control group received unfractionated heparin anticoagulant therapy. After intravenous injection of 80 mg.kg-1, the patients were intravenously injected according to the weight of 18 U.kg-1, and the partial activation of coagulation function reached 1.5-2.5 times. After stabilization for 2 days, To 3 mg.kg-1, adjusted warfarin to 2 ~ 3 mg.kg-1, stable 2 d after the withdrawal of heparin. The curative effect, adverse reaction, hospitalization time and cost of the two groups were observed. Results LMWH was superior to unfractionated heparin in controlling non-large-scale pulmonary embolism in terms of control of symptoms and effects, while ADR was superior to unfractionated heparin in terms of adverse reactions, hospital expenses and hospital stay. Conclusion The treatment of non-large area pulmonary embolism with LMWH is more effective than unfractionated heparin, with fewer adverse reactions, lower cost and worthy of clinical promotion.