肺动脉球囊扩张成形术治疗慢性血栓栓塞性肺动脉高压患者的疗效及不良反应观察  

Observation on the therapeutic effect and adverse reactions of balloon pulmonary angioplasty treating patients with chronic thrombotic pulmonary hypertension

作　　者：赵丹 龚娟妮[1] 唐小红 向梅 杨媛华[1] 崔英[1] ZHAO Dan;GONG Juan-ni;TANG Xiao-hong;XIANG Mei;YANG Yuan-hua;CUI Ying(Department of Respiratory and Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

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

出　　处：《中国医刊》2019年第12期1308-1311,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金（31670928）

摘　　要：目的总结肺动脉球囊扩张成形术(balloon pulmonary angioplasty,BPA)治疗慢性血栓栓塞性肺动脉高压(chronic thromboembolic pulmonary hypertension,CTEPH)的疗效及并发症发生情况。方法回顾性分析2017年2月至2018年12月于首都医科大学附属北京朝阳医院行BPA的40例CTEPH患者的临床资料,总结其6分钟步行距离、血流动力学变化及不良反应发生情况。结果40例CTEPH患者共接受BPA 105次,平均每例患者2.6次。40例患者治疗后6分钟步行距离增加80.39m,平均肺动脉压下降(10.02±1.47)mmHg,肺血管阻力下降(377.9±116.9)dyn·sec/cm5。有11例次发生与手术相关的并发症(室上性心动过速1例次、肾功能不全1例次、穿刺部位血肿1例次、尿潴留1例次、术中咯血5例次、碘造影剂不良反应2例次),发生率为9.55%,经过治疗后均恢复。结论BPA是治疗CTEPH的有效方法,但存在一定的并发症,及时观察和处理相关并发症,是提高救治成功率的关键。Objective To summarize the efficacy and complications of balloon pulmonary angioplasty(BPA)treating patients with chronic thrombotic Pulmonary hypertension(CTEPH),then propose the management methods.Method The clinical data of 40 CTEPH patients who had BPA from February 2017 to December 2018 in Beijing Chaoyang Hospital were analyzed retrospectively,and the 6-minute walking distance,hemodynamic changes and adverse reactions were summarized.Result Forty patients with CTEPH total received BPA 105 times.On average,each patient underwent BPA 2.6 times.The walking distance of 6 minutes after surgery increased 80.39 meters.Mean pulmonary artery pressure decreased(10.02±1.47)mmHg,and pulmonary vascular resistance decreased(377.9±116.9)dyn·sec/cm5.There were 11 cases of operation-related complications(1 case of supraventricular tachycardia,1 case of renal insufficiency,1 case of hematoma at puncture site,1 case of urinary retention,5 cases of intraoperative hemoptysis,and 2 cases of adverse reactions to iodine contrast agent)with an incidence of 9.55%.All the cases recovered after treatment.Conclusion BPA is an effective method to treat CTEPH,but BPA with a high incidence of complications.Therefore,the key to improve the success rate of treatment is to develop the standarized BPA caring procedures,including applying multiple methods to evaluate treatment effects,monitoring vital signs closely,observing and treating related complications in time.

关 键 词：慢性血栓栓塞性肺动脉高压 肺动脉球囊扩张成形术 不良反应 

分 类 号：R543.2[医药卫生—心血管疾病]