肺动脉内介入治疗急性大面积肺栓塞  

Initial experience of emergent intrapulmonary interventional therapy for acute massive pulmonary thromboembolism

作　　者：陈继红[1] 高宇飞[2] 吴炳祥[1] 刘今秀[3] 

机构地区：[1]哈尔滨医科大学第一临床医学院干部一病房,黑龙江哈尔滨150001 [2]黑龙江省医院急诊科,黑龙江哈尔滨150056 [3]黑龙江省中医医院,黑龙江哈尔滨150030

出　　处：《哈尔滨医科大学学报》2008年第2期193-195,共3页Journal of Harbin Medical University

摘　　要：目的探讨肺动脉内介入治疗对急性大面积肺栓塞患者的疗效及安全性。方法经紧急肺动脉造影确诊后,立即在肺动脉内行导管碎栓、吸栓及局部尿激酶溶栓治疗,观察处理前后肺循环改善情况。结果15例经紧急肺动脉造影确诊急性大面积肺栓塞患者(男11例,女4例),术前平均肺动脉压(34±5)mmHg、动脉血氧分压(33±7)mmHg,术后分别为(19±3)mmHg(、68±5)mmHg,与治疗前比较均有统计学意义(P<0.001)。结论用普通导管紧急肺动脉内碎栓、吸栓、溶栓治疗能迅速改善急性大面积肺栓塞时患者的肺循环梗阻状况,改善临床症状,未见明显并发症,安全、有效、经济。Objective To evaluate the safety and effect of intrapulmonary interventional therapy for patients with acute massive pulmonary thromboembolism（PTE）.Methods Pulmonary angiography was followed by intrapulmonary fragmentation and sucking of massive pulmonary embolism using cathethers and contact thrombolysis with urokinase.The changes of pulmonary circulation as well as clinical manifestations before and after treatment were compared.Results Fifteen patients（11 males,4 females） with unstable hemodynamics were diagnosed as acute massive PTE.Mean pulmonary arterial pressure were from（34±5）mmHg to（19±3）mmHg,arterial partial pressure of oxygen were from（33±7）mmHg to（68±5）mmHg（P〈0.001）.No patient showed severe complications.Conclusion The emergent intrapulmonary interventional therapy may be effective,safe,and economic for treatment of acute massive pulmonary embolism,and can improve pulmonary obstruction and decrease clinical symptoms without significant complications.

关 键 词：肺栓塞 介入治疗 尿激酶 

分 类 号：R563.5[医药卫生—呼吸系统]