摘要
目的：探讨导管碎栓联合局部灌注瑞替普酶溶栓治疗高危肺动脉栓塞的疗效及安全性。方法高危肺动脉栓塞患者26例，经肺动脉内导管碎栓和局部灌注瑞替普酶溶栓治疗，观察处理前后肺循环改善情况，分析心肺血流动力学的改变。结果26例高危肺栓塞患者，术前平均肺动脉压、动脉血氧分压和血压分别为（63.78±6.89）mmHg、（73.23±11.51）mmHg和（87.35±10.92）mmHg。术后分别为（26.23±10.27）mmHg、（93.48±6.17）mmHg和（127.14±13.15）mmHg，与治疗前比较差异均有统计学意义（P〈0.01）。随访6～36个月，25例疗效持续，1例复发。结论肺动脉内导管碎栓联合局部灌注瑞替普酶溶栓治疗能迅速改善高危肺栓塞患者肺循环梗阻状况和临床症状，无明显并发症，对维持血流动力学稳定有很好作用。
Objective To evaluate the clinical effect and safety of transcatheter thrombus-breaking combined with local infusion of reteplase （rPA） in treating severe pulmonary thromboembolism （PTE）. Methods During the period from June 2010 to June 2013 at authors’ hospital, transcatheter thrombus-breaking combined with local infusion of reteplase was carried out in 26 patients （17 males and 9 females） with severe pulmonary embolism. The changes of pulmonary circulation and the cardio - pulmonary hemodynamics after the treatment were analyzed. Results The preoperative mean pulmonary artery pressure, arterial blood oxygen partial pressure and the blood pressure were （63.78 ± 6.89） mmHg, （73.23 ± 11.51） mmHg and （87.35 ± 10.92） mmHg respectively, while the postoperative ones were （26.23 ± 10.27） mmHg, （93.48 ± 6.17） mmHg and（127.14 ± 13.15） mmHg respectively, and the differences between preoperative and postoperative ones were statistically significant （P〈0.01）. All the patients were followed up for 6 - 36 months. Significant stable clinical improvement was obtained in 25 patients, and recurrence was seen in one patient. Conclusion Transcatheter thrombus-breaking combined with local infusion of reteplase can quickly improve the pulmonary circulation and the clinical conditions for patients with severe pulmonary thromboembolism, and it has no obvious complications. This technique carries excellent value in maintaining the stability of hemodynamics.
出处
《介入放射学杂志》
CSCD
北大核心
2014年第10期870-873,共4页
Journal of Interventional Radiology
关键词
高危肺栓塞
瑞替普酶
肺动脉
溶栓术
severe pulmonary embolism
reteplase
pulmonary artery
thrombolysis
