伴有心搏骤停疑诊肺血栓栓塞症患者溶栓治疗的效果评价  

Effects of thrombolytic therapy in patients with cardiac arrest from suspected pulmonary thromboembolism

作　　者：尉艳霞[1] 翟振国[1] 邝土光[1] 谢万木[1] 杨媛华[1] 

机构地区：[1]北京呼吸疾病研究所北京市呼吸与肺循环疾病重点实验室首都医科大学附属北京朝阳医院呼吸与危重症医学科,100020

出　　处：《中华医学杂志》2015年第30期2424-2427,共4页National Medical Journal of China

基　　金：国家科技支撑计划课题（2011BAI11B17）;围家卫生行业科研专项（201302008）;首都卫生发展科研专项（首发2011-1004-03）;北京市科技新星计划（20078037）

摘　　要：目的 评价对伴有心搏骤停疑诊肺血栓栓塞症（PTE）患者进行重组组织型纤溶酶原激活剂（rt-PA）溶栓的疗效.方法 回顾性分析2010年1月至2014年6月在北京朝阳医院所有住院患者中伴有心搏骤停高度怀疑PTE,并且在心肺复苏过程中进行rt-PA 50 mg静脉溶栓的12例患者的临床资料,记录其一般资料,并对其溶栓的有效性、安全性及预后进行分析.结果 12例患者中,男6例,女6例,年龄16～81岁,平均（54.8±18.6）岁.外科住院患者7例,围手术期患者6例.溶栓前复苏时间17 ～ 90 min,平均（47.8±26.0）min.9例恢复自主循环,自主循环恢复时间5～20min,平均（15.8±5.4）min,24 h生存8例.溶栓后存在出血并发症4例,其中危及生命的2例,出院长期生存患者4例.结论 对伴有心搏骤停疑诊PTE患者进行rt-PA 50 mg溶栓治疗,有利于自主循环恢复,提高24 h生存率.Objective To explore the effects of thrombolytic therapy with recombinant tissue-type plasminogen activator （rt-PA） in patients with cardiac arrest from suspected pulmonary thromboembolism （PTE）.Methods A total of 12 hospitalized patients with cardiac arrest from suspected pulmonary embolism at Beijing Chaoyang Hospital from January 2010 to June 2014 were retrospectively studied.Thrombolysis was given only as a single dose of 50 mg of rt-PA during cardiopulmonary resuscitation.And their clinical features,effocacies and outcomes of thrombolysis were analyzed.Results There were 6 males and 6 females with a mean age of （54.8-± 18.6）（16-81） years.Seven patients were hospitalized in surgery ward while another 6 perioperatively.The mean time of resuscitation before thrombolysis was （47.8 ± 26.0） （17-90） min.Nine patients regained spontaneous circulation.The mean time of restored spontaneous circulation was （15.8 ± 5.4） （5-20）.The 24-hour survival rate was 8/12.Four patients had bleeding complications,but only 2 life-threatening major cases.Four patients obtained a long-term survival.Conclusion For suspected PTE patients with sudden cardiac arrest,thrombolysis therapy with 50 mg of rt-PA may restore spontaneous circulation and boost 24-hour survival rate.

关 键 词：肺栓塞 心脏停搏 血栓溶解疗法 纤溶酶原激活剂 治疗结果 

分 类 号：R563.5[医药卫生—呼吸系统]