高危肺栓塞的介入治疗10年回顾  

Interventional Therapy for High Risk Pulmonary Embolism: a Review of Ten Years

作　　者：傅军[1] 李选[1] 韩金涛[1] 王昌明[1] 栾景源[1] 李天润[1] 翟国钧[1] 冯琦琛[1] 庄金满[1] 赵军[1] 董国祥[1] 

机构地区：[1]北京大学第三医院介入血管外科,北京100191

出　　处：《中国微创外科杂志》2015年第1期13-18,共6页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨高危肺栓塞进行介入治疗的安全性及有效性。方法回顾性分析2002年12月～2012年9月94例高危肺栓塞接受术中取栓、术中快速溶栓及术后溶栓抗凝、机械碎栓等手段治疗的临床资料，观察术后生命体征、心功能变化及病情转归，总结随访结果。结果技术成功率98．9％（1例未完成手术操作即死亡）；围手术期死亡6例。72例平均随访33．5月（13～130个月），16例失访，随访率81．8％（72／88）。心功能分级：Ⅰ级68例，Ⅱ级3例，Ⅳ级1例，按照我们疗效标准，完全缓解68例（94．4％，68／72），部分缓解3例（4．2％，3／72），无效1例（1．4％，1／72）。结论高危肺栓塞介入治疗是有效的方法，可快速有效改善高危PE患者的预后。Objective To explore the safety and efficacy of interventional therapy for high-risk pulmonary embolism. Methods We retrospectively analyzed 94 cases of high-risk pulmonary embolism who received interventional therapy （ thrombectomy, rapid thrombolysis plus anticoagulation, or mechanical embolus removal） from December 2002 to September 2012.Vital signs, heart functions, and clinical outcomes were observed and compared. Results Among the 94 cases, the success rate of operation was 98.9%（1 patient died during the interventional procedure）.Six patients died after operation.In the remaining 88 cases, loss of follow-up occurred in 16 cases and 72 cases were followed for an average of 23.5 months （13-130 months）, the rate of follow-up being 81.8%（72/88） .The cardiac functions were classified as class Ⅰ in 68 cases, class Ⅱ in 3 cases, and class Ⅳ in 1 case. According to our criteria, there were 68 cases of complete remission （94.4%, 68/72）, 3 cases of partial improvement （4.2%, 3/72）, and 1 case of inefficacy （1.4%, 1/72）. Conclusion Interventional treatment for high-risk pulmonary embolism is an effective procedure, which can quickly and efficiently improve the prognosis and the life quality.

关 键 词：肺栓塞 介入治疗 

分 类 号：R563.5[医药卫生—呼吸系统]