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目的观察低分子量肝素联合华法林治疗晚期肺癌并非大面积急性肺栓塞的临床疗效。方法选取2011年9月—2015年9月无锡市第二人民医院收治的晚期肺癌并非大面积急性肺栓塞患者86例,采用随机数字表法分为对照组和观察组,每组43例。对照组仅给予低分子量肝素治疗,观察组在对照组基础上给予华法林治疗。比较两组患者治疗前后氧分压(PO_2)、二氧化碳分压(PCO_2)、血氧饱和度(SaO_2)、血清D-二聚体水平、英国医学研究委员会(MRC)呼吸困难量表评分,临床疗效及不良反应发生情况。结果两组患者治疗前PO_2、PCO_2、SaO_2及血清D-二聚体水平比较,差异无统计学意义(P>0.05);观察组患者治疗后PO_2、SaO_2均高于对照组,PCO_2及血清D-二聚体水平均低于对照组(P<0.05)。两组治疗前MRC呼吸困难量表评分比较,差异无统计学意义(P>0.05);观察组患者治疗后MRC呼吸困难量表评分低于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论低分子量肝素联合法华林治疗晚期肺癌并非大面积急性肺栓塞的临床疗效确切,可有效改善患者病情,减轻患者呼吸困难症状。
Objective To observe the clinical efficacy of low molecular weight heparin combined with warfarin in the treatment of advanced lung cancer is not large-scale acute pulmonary embolism. Methods Seventy-six patients with advanced lung cancer who were admitted to Second People’s Hospital of Wuxi City from September 2011 to September 2015 were randomly divided into control group and observation group with 43 cases in each group. The control group was treated with low molecular weight heparin only. The observation group was treated with warfarin on the basis of the control group. The changes of partial pressure of oxygen (PO_2), partial pressure of carbon dioxide (PCO_2), blood oxygen saturation (SaO_2) and serum D-dimer before and after treatment were compared between the two groups. The British Medical Research Council (MRC) Efficacy and adverse reactions occurred. Results There was no significant difference in the levels of PO_2, PCO_2, SaO_2 and serum D-dimer between the two groups before treatment (P> 0.05). PO_2 and SaO_2 in the observation group were higher than those in the control group, PCO_2 and serum D - dimer levels were lower than the control group (P <0.05). There was no significant difference in scores of MRC dyspnea before treatment in both groups (P> 0.05). The score of MRC dyspnea after treatment in the observation group was lower than that of the control group (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion Low molecular weight heparin combined with Fahrenheit in the treatment of advanced lung cancer is not a large area of acute pulmonary embolism, the exact clinical efficacy, can effectively improve the patient’s condition, reduce symptoms of dyspnea in patients.