大块肺栓塞和次大块肺栓塞的溶栓治疗  

Fibrinolysis of Massive and Submassive Pulmonary Embolism

作　　者：赵梦华[1] 石建平[1] 徐宝元[1] 

机构地区：[1]邯郸市中心医院心内科,河北邯郸056001

出　　处：《医学综述》2012年第19期3223-3225,共3页Medical Recapitulate

摘　　要：虽然临床指南可为急性肺栓塞(PE)的治疗提供一定的帮助,但急性PE的最优化治疗目前并不十分明确,现讨论大块PE和次大块PE的溶栓治疗。结论为轻、中度PE患者溶栓治疗的风险明显大于获益,因而不应给予溶栓治疗。大块PE患者非常明确可从溶栓治疗中获益,因此只要没有禁忌证就应给予溶栓治疗;次大块PE患者是否给予溶栓治疗是临床医师所面临的难题,需权衡患者的获益和风险。Despite the publication of evidence-based clinical practice guidelines can provide a certain aid in the management of acute pulmonary embolism, the clinician is frequently confronted with manifestation of massive and submassive pulmonary embolism and optimal management is unclear. Here is to address the fi- brinolysis of massive and submassive pulmonary embolism. Patients with low-risk pulmonary embolism have an unfavorable risk-benefit ratio with fibrinolysis, therefore fibrinolysis should not be given. Patients with mas- sive pulmonary embolism probably do benefit from fibrinolysis, therefore fibrinolysis should be given as long as there is no contralndlcation. Managenment of submassive pulmonary embolism crosses the zone of equi- poise, requiring the clinicians to use clinical judgment.

关 键 词：肺栓塞 治疗 纤维蛋白溶解 

分 类 号：R563.5[医药卫生—呼吸系统] R453.9[医药卫生—内科学]