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目的探讨介入治疗急性高危肺栓塞的方法和疗效。方法 8例急性高危肺栓塞患者,肺动脉造影明确栓子部位,行经皮肺动脉导管搅拌碎栓术+溶栓治疗。观察临床症状改善情况、肺动脉血栓清除情况、SpO2、肺动脉平均压(MPAP)的变化。其中6例合并下腔静脉血栓或/和髂股静脉血栓形成者,介入血栓清除前放置下腔静脉滤器。结果 8例患者的血栓均成功大部分清除,术后临床症状明显改善,SpO2明显上升[(78.2±7.0)%vs.(90.2±7.8)%](P<0.05),MPAP明显下降[(38.5±10.8)mm Hg vs.(26.2±8.5)mm Hg](P<0.05)。无严重手术并发症发生。术后随访6-18个月,无栓塞复发。结论介入治疗急性高危肺动脉栓塞,创伤小,疗效好。
Objective To investigate the interventional treatment of acute high-risk pulmonary embolism and efficacy. Methods Eight patients with acute high-risk pulmonary embolism, pulmonary embolism clear embolization, percutaneous pulmonary artery catheterization and thrombolysis thrombolytic therapy. To observe the improvement of clinical symptoms, pulmonary thrombosis, SpO2, pulmonary artery mean pressure (MPAP) changes. Among them, 6 cases were complicated with IVC and / or IJV, and the inferior vena cava filter was placed before the thrombus was removed. Results Most of the 8 patients had successful removal of thrombus, and the postoperative clinical symptoms were significantly improved. The SpO2 was significantly increased [(78.2 ± 7.0) vs (90.2 ± 7.8)%] (P <0.05) ± 10.8) mm Hg vs. (26.2 ± 8.5) mm Hg] (P <0.05). No serious surgical complications occurred. The patients were followed up for 6-18 months without embolism recurrence. Conclusion Interventional treatment of acute high-risk pulmonary embolism, trauma, good effect.