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利伐沙班治疗肺栓塞患者的临床观察及相关护理干预
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| 篇名： | 利伐沙班治疗肺栓塞患者的临床观察及相关护理干预 |
| TITLE： | |
| 摘要： | 目的：观察利伐沙班治疗肺栓塞患者的疗效、安全性。方法：选取肺栓塞患者100例，按随机数字表法分为观察组和对照组，各50例。两组患者均采用护理干预进行康复治疗，并于尿激酶20 000 IU/（kg·h），ivgtt，2 h溶栓治疗。观察组患者给予利伐沙班15 mg，bid，连续治疗3周，3周后改为20 mg，qd 。对照组患者给予低分子肝素钙1 mg/kg，bid ，联合华法林钠5 mg，qd，联合给药≥5 d后，至国际标准化比值（INR）为2～3时，停用低分子肝素钙，单独口服华法林钠。两组疗程均为3个月。观察两组患者临床疗效及治疗前后氧分压（PaO2）、二氧化碳分压（PaCO2）、D-二聚体水平，并记录咳嗽、胸痛、呼吸困难等临床症状缓解情况及不良反应发生率。结果：观察组患者有效率（90.0％）显著高于对照组（74.0％），差异有统计学意义（P＜0.05）。治疗后，两组患者PaO2、PaCO2水平明显高于治疗前，D-二聚体水平明显低于治疗前，且观察组变化幅度明显大于对照组，差异有统计学意义（P＜0.05）。观察组患者咳嗽、胸痛、呼吸困难等临床症状缓解率明显高于对照组，差异有统计学意义（P＜0.05）。观察组患者不良反应发生率（12.0％）显著低于对照组（30.0％），差异有统计学意义（P＜0.05）。结论：利伐沙班辅以合理的护理干预能显著提高肺栓塞患者的临床疗效，且不良反应发生率低。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of rivaroxaban in the treatment of pulmonary embolism. METHODS： 100 patients with pulmonary embolism were selected and randomly divided into observation group and control group， with 50 cases in each group. Both groups were given nursing intervention for rehabilitation. Observation group was treated with rivaroxaban 15 mg， bid， for consecutive 3 weeks， 3 weeks later adjusting to 20 mg， qd； control group was given low molecular weight heparin 1 mg/kg， bid， combined with warfarin sodium 5 mg， qd， for more than 5 days， stopped taking low molecular weight heparin until the INR reached the target 2-3 and given warfarin alone orally. Treatment course of 2 groups lasted for 3 months. Clinical efficacy of 2 groups were observed， and PaO2， PaCO2 and D-dimer levels were observed in 2 groups before and after treatment； the improvement of clinical symptoms as cough， pectoralgia， dyspnea， and the incidence of ADR were recorded in 2 groups. RESULTS： The total effective rate of observation group （90.0％） was significantly higher than that of control group （74.0％）， with statistical significance （P＜0.05）. After treatment， PaO2， PaCO2 and D-dimer levels of 2 groups were increased significantly， compared with before treatment； the observation group was higher than the control group， with statistical significance （P＜0.05）. The remission rate of clinical symptoms as cough， pectoralgia， dyspnea in observation group was significantly higher than in control group， with statistical significance （P＜0.05）. The incidence of ADR in observation group （12.0％） was significantly lower than in control group （30.0％）， with statistical significance （P＜0.05）. CONCLUSIONS： Rivaroxaban supplemented by reasonable nursing intervention can effectively improve clinical efficacy of patients with pulmonary embolism with low incidence of ADR. |
| 期刊： | 2016年第27卷第8期 |
| 作者： | 刘素霞，许亚平，蔡静，郭丽萍 |
| AUTHORS： | LIU Suxia，XU Yaping，CAI Jing，GUO Liping |
| 关键字： | 利伐沙班；肺栓塞；低分子肝素；华法林钠；护理干预 |
| KEYWORDS： | Rivaroxaban； Pulmonary embolism； Low molecular weight heparin； Warfarin sodium； Nursing intervention |
| 阅读数： | 378 次 |
| 本月下载数： | 3 次 |
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