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急性肺栓塞的介入治疗 被引量:18

Catheter-directed therapy in acute pulmonary embolism
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摘要 目的观察介入治疗(catheter—directed therapy,CDT)急性肺栓塞(acute pulmonary embolism,APE)的临床疗效。方法回顾性分析北京大学人民医院2006年1月至2015年12月收治的患有急性肺栓塞。并接受介入治疗(包括机械碎栓术、经导管血栓抽吸术、局部溶栓术及下腔静脉滤器置入术)11例患者的临床资料,观察患者的临床症状、生命体征、血氧饱和度、动脉血氧分压及肺动脉血流等方面在治疗前后的变化。结果术中造影显示:11例栓塞肺动脉6例(54.5%)完全开通,4例(36.4%)部分开通,1例(9.1%)未开通。10例技术成功的患者,术后24h血氧饱和度由(95.4±1.9)%升至(98.3±0.6)%,动脉血氧分压由(79.9±6.6)%升至(97.9±1.0)%,治疗前后差异有统计学意义(P〈0.05);10例患者(90.91%)即刻临床症状有明显改善,并在术后2周取出下腔静脉滤器前未再次发生肺栓塞。结论介入治疗急性肺栓塞创伤较小,能及时有效地处理肺动脉栓塞病变,可以改善临床症状及呼吸功能。 Objective To observe the efficiency of catheter-directed therapy (CDT) for acute pulmonary embolism (APE). Methods We retrospectively analyzed 11 cases of acute pulmonary embolism who received catheter-directed therapy (including thrombus fragmentation with pigtail catheter, suction thrombectomy with aspiration catheter, intraclot thrombolysis and inferior vena cava filter insertion) from January 2006 to December 2015 in our hospital. Results Thrombus in pulmonary arteries were cleared completely in 6 patients (54. 5% ), partially cleared in 4 patients (36. 4% ), and the obstruction was not relieved in 1 patient (9. 1% ). Oxygen saturation rised from (95.4 ±1.9 ) % to (98.3 ± 0. 6 ) %, and that the partial pressure of oxygen in arterial blood rised from (79.9± 6.6) % to (97.9 ±1.0) % (P 〈 0. 05 ). Conclusions With minimal invasion, CDT can alleviate the embolism in pulmonary arteries, improve the clinical symptoms and respiratory function in APE patients.
出处 《中华普通外科杂志》 CSCD 北大核心 2017年第2期129-132,共4页 Chinese Journal of General Surgery
关键词 肺栓塞 机械溶栓 血管腔内治疗 Pulmonary embolism Mechanical thrombolysis Endovascular therapy
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