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目的研究经导管肺动脉局部溶栓与外周静脉全身溶栓在急性肺栓塞性肺动脉高压治疗中的作用。方法20只小猪自体血栓注入建立急性肺栓塞性肺动脉高压模型。随机分成两组:经导管肺动脉局部溶栓(A组10只),外周静脉全身溶栓(B组10只)。溶栓前、溶栓后2h测肺动脉压,肺动脉收缩压(PASP),心率(HR),心输出量(CI),血气分析(PaO2、PaCO2、pH),纤溶酶_抗纤溶酶复合物(PAP),DD二聚体(DD),一氧化氮(NO)。结果两组肺动脉压、CI、PaO2、PaCO2、PAP、DD、NO均较治疗前有显著变化(P<0.05),A组的肺动脉压、PaO2、PaCO2、PAP的变化较全身溶栓组B组的变化更显著(P<0.05)。结论肺栓塞治疗中局部溶栓的疗效优于全身溶栓。
Objective To study the role of local thrombolysis in pulmonary artery and peripheral thrombolysis in the treatment of acute pulmonary embolism pulmonary hypertension. Methods Twenty piglets were injected with autologous thrombus to establish acute pulmonary embolism pulmonary hypertension model. Randomly divided into two groups: local thrombolysis through the catheter pulmonary artery (A group of 10), peripheral venous thrombolysis (B group of 10). Pulmonary arterial pressure, pulmonary artery systolic pressure (PASP), heart rate (HR), cardiac output (CI), blood gas analysis (PaO2, PaCO2, pH), plasmin- (PAP), DD dimer (DD), nitric oxide (NO). Results The changes of pulmonary arterial pressure, PaO2, PaCO2, PaCO2, PaCO2, PaO2, PaCO2, PaO2, PaO2, PaO2, The changes were more significant (P <0.05). Conclusion The efficacy of local thrombolysis in pulmonary embolism is better than systemic thrombolysis.