尿激酶溶栓联合经皮导管碎栓在肺动脉栓塞中的临床应用  

Clinical application of urokinase thrombolysis combined with percutaneous thrombolysis in pulmonary embolism

作　　者：许学明[1] 李慧娟[2] 张志业[1] 武政喜[1] 米占广 XU XueMing;LI Huijuan;ZHANG Zhiye;WU Zhengxi;MI Zhanguang(Department of General Surgery,The First People′s Hospital of Shizuishan,Shizuishan 753000,China;Department of Obstetrics and Gynecology,The First People′s Hospital of Shizuishan,Shizuishan 753000,China)

机构地区：[1]宁夏石嘴山市第一人民医院普外科,宁夏石嘴山753200 [2]宁夏石嘴山市第一人民医院妇产科,宁夏石嘴山753200

出　　处：《宁夏医学杂志》2021年第1期44-47,共4页Ningxia Medical Journal

基　　金：宁夏石嘴山市科技攻关项目(201817)。

摘　　要：目的探讨经皮导管碎栓联合尿激酶溶栓在肺动脉栓塞中的临床疗效和安全性分析。方法选取肺动脉栓塞患者32例,分为介入溶栓组(实验组)和系统溶栓组(对照组),每组各16例。介入溶栓组患者给予经皮导管碎栓、吸栓联合尿激酶局部灌注溶栓,系统溶栓组经外周静脉输注尿激酶溶栓治疗。对比2组患者治疗后的临床疗效和并发症发生情况。对比2组患者治疗前后密勒指数(MI)、休克指数(SI)、肺动脉收缩压(sPAP)和动脉血氧分压(PaO 2)水平及心率(HR)、呼吸频率(RR)和D-二聚体(D-D)水平。结果治疗后,介入溶栓组总有效率较高(P<0.05);治疗前2组患者MI、SI、sPAP和PaO 2水平无差异(P>0.05);2组患者治疗后MI、SI、sPAP水平显著降低,PaO 2水平明显升高(P<0.05);并且介入溶栓组改善较多(P<0.05);治疗前2组患者HR、RR和D-D水平无差异(P>0.05);2组患者治疗后HR、RR和D-二聚体水平显著降低(P<0.05);并且介入溶栓组降低较多(P<0.05)。结论采用经皮导管碎栓联合尿激酶溶栓治疗肺动脉栓塞,具有较好的临床疗效,能够迅速缓解临床症状,安全性较高,值得在临床上推广应用。Objective To investigate the clinical efficacy and safety of percutaneous thrombolysis combined with urokinase in pulmonary embolism.Methods 32 patients with pulmonary embolism treated in our hospital were randomly divided into interventional thrombolysis group(experimental group,n=16)and systematic thrombolysis group(control group,n=16).In the interventional thrombolytic group,the patients were given percutaneous thrombolysis combined with thrombolytic aspiration and thrombolysis by local infusion of urokinase,and in the systemic thrombolytic group,thrombolytic therapy by peripheral intravenous infusion of urokinase was administered.The clinical efficacy and complications of the two groups were compared.The Miller indices(MI),shock index(SI),systolic pulmonary artery pressure(sPAP),and partial arterial oxygen pressure(PaO 2),Heart rate(HR),Respiratory rate(RR)and d-dimer(d-dimer,d-d)levels were compared before and after treatment.Results After treatment,the total effective rate of interventional thrombolysis group was higher(P<0.05).Before treatment,there was no difference in the levels of MI,SI,sPAP and PaO 2 between the two groups(P>0.05).After treatment,the levels of MI,SI and sPAP in the two groups were significantly decreased and the levels of PaO 2 were significantly increased(P<0.05).In addition,the interventional thrombolysis group improved significantly(P<0.05).There was no difference in HR,RR and d-d levels between the two groups before treatment(P>0.05).After treatment,HR,RR and d-dimer levels were significantly reduced in the two groups(P<0.05).In addition,the interventional thrombolysis group had a significant reduction(P<0.05).Conclusion Thrombolytic therapy with percutaneous thrombectomy combined with urokinase for pulmonary embolism has good clinical efficacy,which can quickly relieve clinical symptoms,and is of high safety.

关 键 词：经皮导管碎栓 尿激酶溶栓 肺动脉栓塞 临床应用 

分 类 号：R543.3[医药卫生—心血管疾病]