Abstract: Objective To analyze the clinical efficacy and safety of low molecular weight heparin combined with warfarin in anticoagulant treatment of acute submassive pulmonary embolism (ASPE), and investigate its application value.Methods 126 patients with ASPE from May 2011 to June 2016 in our hospital were involved in the study and randomly divided into two groups, including 63 patients who received the low molecular weight heparin combined with warfarin anticoagulant therapy as the observation group, while 63 cases who were treated with low molecular weight heparin and warfarin anticoagulant therapy combined with urokinase thrombolytic therapy as the control group. Changes of clinical indexes of patients before and after treatment were compared between the two groups, and the efficacy and safety of the two therapeutic strategies were analyzed. Results Compared with the levels before treatment, the PaO₂, PaCO₂, RVEF in both of the two groups increased, the P(A-a)O₂, RVESVI, RVEDVI, PS, PC, D-D, t-PA, PAI-1, TM decreased after treatment, the difference was statistically significant (P < 0.05). After treatment, there was no significant difference of the arterial blood gas indexes between the two groups (P > 0.05). The total effective rate of the observation group and the control group were 92.06% and 93.65% respectively, without statistical difference between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was 6.35%, which was lower than that in the control group of 26.98%, the difference was statistically significant (P < 0.05). Conclusion Low molecular weight heparin combined with warfarin in anticoagulant treatment of patients with ASPE can obtain a similar effect as the strategy supplementary with thrombolytic therapy, and with lower incidence of adverse reactions and better safety.

Key words: low molecular weight heparin, warfarin, anticoagulation, thrombolysis, acute submassive pulmonary embolism, clinical efficacy, safety