Clinical analysis of different regimens on acute pulmonary thromboembolism with deep venous thrombosis

Abstract

Objective To evaluate the efficacy of thrombolytic therapy and/or anticoagulantion with low molecular weight heparin in patients with acute intermediate pulmonary thromboembolism (PTE) with deep venous thrombosis (DVT).Methods This article was a retrospective study of 73 patients date from January 2006 to May 2011 with computed tomographic pulmonary angiography and ultrasonic diagnosed acute intermediate PTE+DVT.All the patients with documented acute intermediate PTE+DVT were treated with two different regimens:thrombolysis combined with anticoagulantion therapy in 39cases,pure anticoagulantion therapy in 34 cases.The D-dimer,blood gas analysis,pulmonary artery systolic pressure (PASP) were compared between the two groups.The diagnosis and treatment processes accorded with the guideline.Results The most common risk factor was trauma and surgery (50.7 ％),then varicose vein (35.6 ％ ).Dyspnea was the most common symptom (95.9 ％ ),crura asymmetrically swollen was the most common sign (79.5％).The two groups had no difference in symptoms,sex and age composition (P ＞0.05).The D-dimer and PASP of both groups significantly elevated,while PaO2decreased ( P ＜ 0.05),and the two groups showed no difference ( P ＞ 0.05).After treatment,the thrombolysis plus amicoagulamion group was significantly better than the pure anticoagulantion group ( P ＜0.05).Major bleeding was not documented.Concluslons Thrombolytic therapy combined with low molecular weight heparin is much more effective for acute intermediate PTE+DVT than anticoagulation alone. Key words: Intermediate pulmonary thromboembolism; Deep venous thrombosis; Thrombolysis; Anticoagulation; Pulmonary artery systolic pressure; Echocardiography