Objective: To observe the clinical efficacy and safety in massive pulmonary embolism of Reteplase (rPA). Methods: A total of 50 patients with massive pulmonary embolism from January 2007 to December 2008 and all of them had no disease of pulmonary and cardiac. They were divided into two groups at random. Experiment group (n=25) was treated with rPA, the control group (n=25) was treated with Urokinase. To observe the symptom, blood gas analysis, the radiography of pulmonary artery spiral CT, pulmonary artery pressure (PAP) and the complication of them in pre/pro thromblytic. Results: The symptom, blood gas analysis, the radiography of pulmonary artery spiral CT and PAP of experiment group were lower than those of the the control group (P＜0.05). The effective rate was 92％ in the experiment group and 76％ in the control group, the experiment group were higher than that of the control group (P＜0.05). The occurrence of bleeding in the experiment group was 1 case of puncture position bleeding, 1 case of gingival bleeding and 2 cases of rhinorrhagia; 1 case of microscopic hematuria, 3 case of gingival bleeding and 2 cases of rhinorrhagia in the control group. Conclusion: Therapy of massive pulmonary embolism with rPA was effective and safe.%目的:观察瑞替普酶治疗大面积肺动脉栓塞的临床疗效及其安全性.方法:回顾我院2007年1月～2008年12月诊断为大面积肺动脉栓塞的患者50例,既往均无心肺疾病,随机进入瑞替普酶组(实验组)和尿激酶组(对照组)进行溶栓治疗,各25例,观察溶栓前后患者的症状、动脉血气分析、螺旋CT肺动脉造影、肺动脉压力及并发症.结果:症状、动脉血气分析、螺旋CT肺动脉造影、肺动脉压力,实验组较对照组明显改善(P<0.05).实验组溶栓后有效率为92%,对照组有效率为76%,实验组治疗有效率高于对照组(P<0.05).实验组出现1例穿刺部位出血、1例牙龈出血、2例鼻出血;对照组出现1例镜下血尿、3例牙龈出血、2例鼻出血.结论:瑞替普酶治疗大面积肺动脉栓塞疗效较好,安全可靠.
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