Objective:To investigate the efficacy and safety of low-dose low-molecular-weight heparin anticoagulation therapy in patients with spontaneous intracerebral hemorrhage (SICH) complicated with pulmonary embolism (PE).Methods:We analyzed 66 cases of SICH patients with PE in the First Affiliated Hospital of Henan University of Science and Technology from January 2011 to December 2016 by retrospective analysis.Patients were divided into control group (Group A:no anticoagulant therapy was given),Full dose anticoagulation group (Group B:low molecular weight heparin 100iU/kg.time,q12h),low dose anticoagulant group (Group C:low molecular weight heparin calcium 3 000iU,q12h/ 5 000iU,qd) according to the different treatment programs;Assess the prognostic factors of SICH patients with PE,comparison of the efficacy,the rate of rebleeding and mortality within 30 days of different doses of anticoagulant in the treatment of pulmonary embolism.Results:1) The prognosis of the disease:result showed that different doses of anticoagulant drugs were important factors influencing the prognosis of patients with SICH and PE (P ＜ 0.05);There was no significant difference in the rate of improvement of pulmonary embolism between the full dose anticoagulation group (group B) and low dose anticoagulation group (group C);C group rebleeding rate and mortality rate was less than B group,the difference was statistically significant(P ＜0.05).Conclusion:Application of low-dose low molecular weight heparin in the treatment of SICH patients with middle and low-risk PE may be an effective and safe method.%目的:探讨自发性脑出血(SICH)合并肺栓塞(PE)患者应用低剂量低分子肝素抗凝治疗的有效性和安全性.方法:回顾性分析2011年1月至2016年12月,河南科技大学第一附属医院收治的SICH合并PE患者66例,根据治疗方案的不同分为对照组(A组:未给予抗凝治疗)、足量抗凝组(B组:低分子肝素钙100iU/kg,1次/12h)、低剂量抗凝组(C组:低分子肝素钙3 000iU,1次/12h/5 000iU,1次/d);评估影响脑SICH合并PE预后的因素;对比不同剂量抗凝治疗肺栓塞疗效、再出血发生率和30d内死亡率.结果:①不同剂量抗凝药物是影响SICH合并PE疾病预后的重要因素(P＜0.05);②足量抗凝组(B组)与低剂量抗凝组(C组)对比肺栓塞疗效评价好转率,差异无统计学意义(P＞0.05);C组再出血率和30d死亡率少于B组,差异有统计学意义(P＜0.05).结论:应用低剂量低分子肝素治疗SICH合并中低危PE患者可能是一种有效、安全的方法.
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