急性肺血栓栓塞症介入治疗现状  

Current status of interventional therapy for acute pulmonary thromboembolism

作　　者：候学智 黄强 HOU Xuezhi;HUANG Qiang(Qinghai Provincial People's Hospital,Xining,Qinghai Province 810000,China)

机构地区：[1]青海省人民医院,青海西宁810000 [2]中日友好医院呼吸中心呼吸与危重症医学科、国家呼吸中心

出　　处：《介入放射学杂志》2024年第9期1027-1033,共7页Journal of Interventional Radiology

摘　　要：急性肺血栓栓塞症(pulmonary thromboembolism, PTE)的危险分层是治疗的导向,针对不同的危险分层采取相应的治疗方案。抗凝治疗是急性PTE治疗的基石,但单纯抗凝治疗与中、高危人群中早期血流动力学失代偿和死亡的风险增加相关;系统溶栓能够快速减轻血栓负荷,缓解右心室功能障碍,可以更早地改善血流动力学,但存在出血的高风险。目前,导管介入治疗正在迅速发展,并发展出了不少与之匹配的装置,旨在更好地完善急性PTE治疗方案,以满足肺栓塞治疗的临床需求。该文虽未对其临床相关应用优势展开对照研究,但是却基于危险分层的治疗思路,对机械性血栓清除装置、吸入性血栓清除装置、裂解性血栓清除装置等不同类型进行了综述,并论述其在各自应用范围内的优势及发展趋势,旨在为当前学术研究进行系统性总结。The risk stratification of acute pulmonary thromboembolism(PTE)is the direction of treatment,and corresponding treatment plans are adopted for patients with different risk stratification.Anticoagulant therapy is the cornerstone of the treatment of acute PTE,but simple anticoagulant therapy is associated with an increased risk of early hemodynamic decompensation and death in the medium to high-risk population.Systematic thrombolysis can quickly reduce the burden of thrombus,alleviate right ventricular dysfunction,and improve hemodynamics earlier,but there is a high risk of bleeding.At present,catheter interventional therapy is rapidly developing and many matching devices have been developed,which aims to better formulate the treatment plan for acute PTE and to better meet the clinical requirements for the treatment of PTE.This article,based on the therapeutic idea of risk stratification,aims to make a comprehensive review about the different types of mechanical thrombectomy devices,inhalation thrombectomy devices and lytic thrombectomy devices,which are currently used in clinical treatment of PTE,although a comparative study on the advantages of their clinical application has not been conducted yet.The advantages and trends of their respective applications are discussed so as to provide a systematic summary of the current academic research in this field.

关 键 词：急性肺血栓栓塞症 危险分层 导管定向溶栓 导管血栓清除术 

分 类 号：R543.5[医药卫生—心血管疾病]