介入治疗急性肺栓塞50例临床分析  

Interventional Therapy for 50 Cases of Acute Pulmonary Embolism

作　　者：杜开亮 汪建中[1] Du Kailiang;Wang Jianzhong(Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学附属医院

出　　处：《北华大学学报（自然科学版）》2019年第4期520-523,共4页Journal of Beihua University（Natural Science）

基　　金：吉林市科技计划项目(201536036)

摘　　要：目的 通过比较分析经肺动脉置管介入治疗肺栓塞(APE)的优势.方法 选择确诊的APE患者共50例,根据患者不同的治疗方案分为外周溶栓组(n=20)和介入溶栓组(n=30);介入溶栓组采用介入治疗,外周溶栓组采用静脉溶栓治疗.分析两组患者治疗前后肺动脉栓塞阻塞体积及肺动脉阻塞指数(PAOI),比较两组患者治疗后D-二聚体恢复正常时间及平均动脉二氧化碳分压(PaCO2)和动脉血氧分压(PaO2)情况.结果 治疗前,介入溶栓组与外周溶栓组血栓体积比较差异无统计学意义(P>0.05);溶栓治疗后,两组患者与治疗前比较血栓体积均明显下降,其中介入溶栓组下降幅度更明显,差异具有统计学意义(P<0.01).治疗后介入溶栓组患者D-二聚体下降至正常水平的时间明显短于外周溶栓组,差异具有统计学意义(P<0.01);介入溶栓组平均PaCO2及PAOI明显低于外周溶栓组,PaO2明显高于外周溶栓组,差异均具有统计学意义(均P<0.01).结论 介入置管溶栓治疗APE可彻底清除大部分肺动脉主干内血栓,较快缓解肺动脉高压及右心功能失代偿,改善患者症状,提高患者远期疗效.Objective To compare and analyze the advantages of pulmonary artery catheterization in the treatment of pulmonary embolism (APE).Method 50 patients with APE were diagnosed and divided into two groups according to the treatment plan,peripheral thrombolysis group ( n =20) and interventional thrombolysis group ( n =30).Interventional thrombolysis group was treated with interventional therapy,and peripheral thrombolysis group was treated with intravenous thrombolysis.The volume of pulmonary embolism was analyzed before and after treatment.The recovery time of D-dimer,mean arterial pressure and arterial partial pressure of oxygen were compared between the two groups. ResultsThere was no significant difference in thrombus volume between interventional thrombolysis group and peripheral thrombolysis group before treatment ( P >0.05).Thrombus volume of both groups after thrombolysis treatment decreased significantly comparing with that before treatment,especially in interventional thrombolysis group ( P <0.01).After treatment,the time of D-dimer decreasing to normal in interventional thrombolysis group was significantly shorter than that in peripheral thrombolysis group ( P< 0.01),the mean arterial pressure in interventional thrombolysis group was significantly higher than that in peripheral thrombolysis group,and the partial pressure of arterial oxygen was significantly lower than that in peripheral thrombolysis group ( P< 0.01).Conclusion Interventional catheter thrombolysis for treating APE can completely remove most of the thrombus in the main pulmonary artery,quickly relieve pulmonary hypertension and right ventricular dysfunction,improve the symptoms of patients and the long-term efficacy of patients.

关 键 词：肺栓塞 介入溶栓 静脉溶栓 

分 类 号：R563.5[医药卫生—呼吸系统]