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目的分析96例肺血栓栓塞症(PTE)溶栓患者的临床特点,探讨该溶栓方案的有效性和安全性。方法分析96例接受溶栓的PTE患者的临床表现、实验室检查和影像学资料。Ⅰ组(62例)病程在2周内;Ⅱ组(26例)病程超过1个月,症状加重2周;Ⅲ组(8例)病程超过2周(最长呼吸困难史5个月),但影像学判断血栓较新鲜。采用尿激酶(75万~150万U)或重组组织型纤溶酶原激活剂(50~100mg)溶栓。综合判断溶栓疗效和安全性。结果74%PTE患者伴有下肢静脉疾患,96%有呼吸困难症状。溶栓后,呼吸频率、心率显著改善(P<0.001)。溶栓总有效率Ⅰ组97%;Ⅱ组73%(与Ⅰ组比较,P=0.001);Ⅲ组100%。结论下肢静脉病是PTE主要诱因,对于不能解释的劳力性呼吸困难、晕厥应高度怀疑PTE。
Objective To analyze the clinical features of 96 patients with pulmonary thromboembolism (PTE) thrombolytic therapy and investigate the effectiveness and safety of the thrombolytic therapy. Methods The clinical manifestations, laboratory tests and imaging data of 96 patients with thrombolytic PTE were analyzed. Group Ⅰ (62 cases) course of disease within 2 weeks; Group Ⅱ (26 cases) course of more than 1 month, the symptoms increased 2 weeks; Ⅲ group (8 cases) course of more than 2 weeks (the longest history of respiratory distress 5 months) However, imaging thrombosis to judge more fresh. Urokinase (750,000 ~ 1.5 million U) or recombinant tissue-type plasminogen activator (50 ~ 100mg) thrombolysis. Comprehensive judgment of thrombolytic efficacy and safety. Results 74% of patients with PTE had venous venous disease and 96% had dyspnea. Respiratory rate and heart rate were significantly improved after thrombolysis (P <0.001). The total effective rate of thrombolytic group Ⅰ 97%; Ⅱ group 73% (compared with Ⅰ group, P = 0.001); Ⅲ group 100%. Conclusions Venous venous disease of the lower extremities is the main cause of PTE. PTE should be highly suspected for unexplained exertional dyspnea and syncope.