术后早期肺栓塞溶栓治疗10例报告  

Thrombolytic therapy for early postoperative pulmonary embolism: a report of ten cases

作　　者：朱雄龙[1] 韩文斌[1] 郑涛[1] 朱世宏[1] 孙金勇[1] 

机构地区：[1]北京军区总医院重症医学科,100700

出　　处：《解放军医学杂志》2012年第12期1139-1141,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨术后早期急性肺栓塞溶栓治疗的可行性,以及溶栓药物、剂量和给药模式的选择。方法对北京军区总医院重症医学科1999年5月-2011年7月收治的10例术后早期急性肺栓塞患者溶栓治疗的临床资料进行回顾性分析,并复习国内外相关文献,总结临床诊治经验。结果 10例急性肺栓塞均诊断明确,一经诊断立即早期进行溶栓治疗,其中7例经中心静脉溶栓,2例经外周静脉溶栓,1例采用介入碎栓溶栓治疗,全部有效,起效时间最快30min,氧合改善最慢为12h。9例治愈,5例患者有一过性局部出血,1例死于感染并发症。结论术后早期有选择地对某些急性肺栓塞患者进行溶栓治疗是安全、可行、有效的。Objective To investigate the feasibility of thrombolytic therapy for early postoperative pulmonary embolism, and the choice of thrombolytic drug, and its dosage and administration route. Methods A retrospective analysis of the clinical data of 10 patients with early acute pulmonary embolism undergoing thrombolytic therapy in our department from 1999 to 2011 was performed, followed by a review of related literature in China and abroad, the experience of the diagnosis and treatment were summarized. Results The diagnosis of 10 cases of acute pulmonary embolism were doubtless. After diagnosis, immediate early thrombolytic therapy was given, including 7 cases of central venous thrombolysis, 2 cases of peripheral intravenous thrombolysis, and 1 case with interventional thrombectomy plus thrombolytic therapy. The treatment was successful in all the patients, with earliest effective time at 30min. After the treatment, and latest improvement in oxygenation at 12 hours. Nine patients were cured, in S patients it was complicated by local bleeding, and 1 patient died of infectious complication. Conclusions Prudent thrombolytic therapy is safe, feasible and effective in the treatment of early postoperative pulmonary embolism.

关 键 词：手术期间 肺栓塞 溶栓 

分 类 号：R563.5[医药卫生—呼吸系统]