论文部分内容阅读
目的观察经皮导管介入治疗急性肺栓塞的疗效。方法选择2003年1月-2009年6月收治的急性肺栓塞患者15例,采用经皮导管吸栓术、碎栓术及溶栓术治疗。溶栓术用局部灌注加即刻静脉注射尿激酶,总量100万U。溶栓后给予低分子肝素7～10d,口服华法林3～6个月。观察临床症状、体征改善情况、并发症、平均肺动脉压(mPAP)与动脉血氧分压(PO2)的变化,以及肺动脉开通情况。结果 12例肺动脉完全开通,3例部分开通,显效率89%,有效率100%。mPAP从(41.07±6.97)mmHg降到(21.00±5.66)mmHg,PO2从(46.26±9.30)mmHg升到(79.49±8.04)mmHg,治疗前后差异有统计学意义(P<0.05)。即刻临床症状明显改善,mPAP迅速降低11例。随访3～6个月,疗效持续,未见复发。结论介入治疗急性肺栓塞疗效显著,安全可行,对抢救危重患者、改善临床症状、维持血流动力学稳定有重要作用。
Objective To observe the effect of percutaneous catheter interventional treatment of acute pulmonary embolism. Methods Fifteen patients with acute pulmonary embolism who were admitted from January 2003 to June 2009 were treated with percutaneous catheter aspiration, thrombectomy and thrombolysis. Thrombolysis with local perfusion plus immediate intravenous injection of urokinase, the total 1 million U. Thrombolytic given low molecular weight heparin 7 ~ 10d, oral warfarin 3 to 6 months. Clinical symptoms, signs of improvement, complications, changes in mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen (PO2), and pulmonary artery opening were observed. Results 12 cases of pulmonary artery completely opened, 3 cases partially open, markedly effective rate of 89%, the effective rate of 100%. mPAP decreased from (41.07 ± 6.97) mmHg to (21.00 ± 5.66) mmHg, PO2 increased from (46.26 ± 9.30) mmHg to (79.49 ± 8.04) mmHg, with significant difference before and after treatment (P <0.05). Immediate clinical symptoms improved significantly, mPAP decreased rapidly in 11 cases. Follow-up 3 to 6 months, the effect continued, no recurrence. Conclusions Interventional treatment of acute pulmonary embolism has obvious curative effect, is safe and feasible, and plays an important role in rescuing critically ill patients, improving clinical symptoms and maintaining hemodynamic stability.