药物联合治疗下肢深静脉血栓形成.docVIP

药物联合治疗下肢深静脉血栓形成[摘要] 目的：探讨采用巴曲酶注射液等药物联合治疗下肢深静脉血栓形成的有效方法。方法：将符合条件的120例患者随机分为治疗组和对照组。治疗组 (65例) 首日给予巴曲酶注射液10 Bu＋生理盐水250 ml静脉滴注，以后隔日给予巴曲酶注射液5 Bu＋生理盐水100 ml静脉滴注，合并使用抗凝（低分子肝素5 000 U皮下注射，bid）、祛聚（低分子右旋糖苷500 ml静脉滴注，qd；拜阿斯匹林100 mg，qd，口服）药物治疗。对照组(55例)给予尿激酶(UK)25万IU加入5%葡萄糖注射液250 ml中，静脉滴注，bid；其他同治疗组。2周后根据患肢消肿程度及磁共振或B超检查结果判断疗效。结果：2周后治疗组和对照组总有效率分别为93.84 %、83.64%(P＜0.05)；未出现严重的出血等并发症。结论：巴曲酶注射液联合抗凝、祛聚药物，是治疗下肢深静脉血栓形成的一种安全、有效的方法。 [关键词] 下肢深静脉血栓形成；巴曲酶注射液；药物治疗 [中图分类号] Ｒ９６９.2[文献标识码]A [文章编号]1673-7210（2008）08（c）-019-03 Combined drug therapy of the deep venous thrombosis PANG Hong-yong (Department of Oncology, the First People’s Hospital of Shangqiu, Shangqiu476100, China) [Abstract] Objective: To explore an effective treatment to the deep venous thrombosis with combined drug such as batroxobin injection. Methods: 120 patients with deep venous thrombosis were randomly divided into two groups: treatment group (n=65), treated with 10 Bu batroxobin injection and 250 ml normal saline by intravenous drip on the first day, then 5 Bu batroxobin injection and 100 ml normal saline were treated by intravenous drip every other day, and combined with anticoagulant therapy (low molecular weight heparin, 5 000 U, ih, bid) as well as disaggregation therapy (low molecular dextran, iv, qd；aspirin enteric coated tablets 100 mg, po, qd). Control group (UK group, n=55) were treated with 250 ml 5% glucose injection containing 250 000 IU Urokinase, iv, bid. The rest were the same as the treatment group. Therapeatic effect was evaluated according to repercussion extent of the wounded leg and the result of magnetic resonance examination or MRI after 2 weeks. Results: The total effective rates of treatment group and control group were 93.84% and 83.64% respectively after 2 weeks (P 1.4观察指标 主要观察指标有：①消肿时间：每日测定患肢周径(以髌骨正中为中心，膝上20 cm及膝下15 cm的周径)；②胀痛缓解情况(完全缓解、久立后胀痛及站立即有胀痛)；③PT、FIB变化；④溶栓2周后患肢深静脉再通情况；⑤出血倾向观察：有无皮肤、黏膜、消化道、呼吸道、泌尿道出血；⑥不良反应 (寒战、高热、皮肤过敏等)。 1.5疗效判定 根据治疗后病人患肢疼痛缓解情况、消肿程度，分为：痊愈――肢