Clinical Evaluation And Duration Of Anticoagulat Therapy In Pulmonary Embolism With Different Risk Factors

Objective:To investigate the duration of anticoagulant therapy and clinical evaluation of different risk factors in patients with pulmonary embolism(PE),and to provide the theoretical and improve patients prognosisguidance for clinical more effectively in the diagnosis and treatment of pulmonary embolism.Methods:The subjects were 90 PE patients diagnosed in department of respiratory medicine of the first hospital of shanxi medical university from September 2012 to December2013,Which were divided into temporary risk factors of PE(group A)、 permanent risk factors of PE(group B)and idiopathic PE(group C)according to its risk factors.All patients were given low molecular heparin sequential warfarin to analysis the duration of anticoagulant therapy and Clinical evaluation between groups.Results:To compared with effect after three months:Dyspnea of group A decreased for(87.5%vs12.5%), group B for(93.3% vs 80.0 %), group C for( 85.7% vs 14.3%),There was statistical significance both A and C group in dyspnea before and after treatment(P <0.05),whether B group On the contrary(P>0.05).In addition,for auxiliary examination:blood gas analysis of p H value、PCO2 and pulmonary arterial hypertension between A and C guoups all turned for the better compared with before treatment, the differences was statistically significant(P<0.05),whether B group On the contrary(P>0.05).Spiral CT pulmonary angiography(CTPA) of pulmonary arteries filling all turned for the better compared with before treatment, Groups of CTPA had statistical significance(P <0.05).Diameter size of Each group all had no statistical significance before and after treatment(P > 0.05);Treatment for six months: A、B and C groups cure rate respectively reached 100%、20.0% and 71.4%.Treatment for twelve months :A、B and C groups curerate reached 100%、53.3% and 100.0%. After treatment with anticoagulation, A、B and C groups of average anticoagulant therapy was(3.56±1.21) months、(15.60±5.46) months、(7.29±3.268) months;the incidence of bleeding respectively was 0.0% 、 16.7% 、7.1%,bleeding rate of group B is higher than the rest of the two groups(all P < 0.05).Conclusions:Different risk factors of PE patients with different anticoagulant therapy and clinical evaluation.Long oral duration of anticoagulant and high bleeding rate were exist for persistent risk factors of pulmonary embolism in patients,in addition, clinical symptoms and auxiliary examination improved slowly.For patients with pulmonary embolism,the duration of anticoagulant therapy must be individualized,were decided after the Comprehensive evaluation of the risk of benefit.