Efficiency of low molecular heparin calcium combined with rivaroxaban in the treatment of elderly patients with advanced lung cancer complicated with pulmonary embolism
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摘要: 目的 探讨低分子肝素钙联合利伐沙班治疗老年晚期肺癌合并肺栓塞的临床效果。 方法 选取老年晚期肺癌合并肺栓塞患者84例,采用随机数字表法分为观察组与对照组各42例,对照组采用低分子肝素钙联合华法林治疗,观察组采用低分子肝素钙联合利伐沙班治疗, 2组均连续治疗3个月。比较2组临床疗效、治疗前后血气分析及凝血功能指标、不良反应发生情况。 结果 观察组疾病控制率(DCR)为85.71%, 高于对照组71.43%, 但差异无统计学意义(P>0.05)。治疗后, 2组患者动脉血氧分压[p(O2)]、血氧饱和度(SpO2)水平显著升高(P<0.05), 动脉血二氧化碳分压[p(CO2)]水平显著下降(P<0.05); 观察组治疗后p(O2)、SpO2水平显著高于对照组(P<0.05), p(CO2)水平显著低于对照组(P<0.05)。治疗后, 2组患者纤维蛋白原(FIB)、D-二聚体(D-D)水平显著下降(P<0.05), 凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)值显著升高(P<0.05); 观察组治疗后FIB、D-D水平显著低于对照组(P<0.05), PT、APTT值显著高于对照组(P<0.05)。治疗期间,观察组患者不良反应发生率为9.52%, 低于对照组的19.04%, 但差异无统计学意义(P>0.05)。 结论 低分子肝素钙联合利伐沙班治疗老年晚期肺癌合并肺栓塞疗效显著,能改善患者呼吸功能及凝血功能。Abstract: Objective To investigate the clinical efficacy of low molecular heparin calcium combined with rivaroxaban in the treatment of elderly patients with advanced lung cancer complicated with pulmonary embolism. Methods Totally 84 elderly patients with advanced lung cancer complicated with pulmonary embolism were selected and randomly divided into observation group and control group, with 42 cases in each group. The control group was treated with low molecular heparin calcium combined with warfarin, while the observation group was treated with low molecular heparin calcium combined with rivaroxaban. Clinical efficacy, indexes of blood gas analysis and coagulation function before and after treatment, and incidence of adverse reactions were compared between two groups. Results The disease control rate(DCR)of the observation group was 85.71%, which was higher than 71.43% of the control group(P>0.05). After treatment, the arterial oxygen partial pressure [p(O2)] and blood oxygen saturation(SpO2)levels significantly increased in both groups(P<0.05), the arterial carbon dioxide partial pressure [p(CO2)] level significantly decreased in both groups(P<0.05), and the p(O2)and SpO2 levels in the observation group were significantly higher than the control group(P<0.05), while the p(CO2)level was significantly lower than the control - group(P<0.05). After treatment, the levels of fibrinogen(FIB)and D-dimer(D-D)significantly decreased in both groups(P<0.05), the values of thrombinogen time(PT)and activated partial thromboplastin time(APTT)significantly increased in both groups(P<0.05), and the levels of FIB and D-D in the observation group were significantly lower than the control group(P<0.05), while the values of PT and APTT were significantly higher than the control group(P<0.05). During treatment, the incidence of adverse reactions in the observation group was 9.52%, which was lower than 19.04% in the control group(P>0.05). Conclusion The efficacy of low-molecular heparin calcium combined with rivaroxaban is effective in the treatment of elderly patients with advanced lung cancer complicated with pulmonary embolism, which can improve the respiratory and coagulation functions of patients.
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