肺动脉血栓抽吸术与肺动脉置管溶栓术在中高危肺栓塞患者中的疗效评价  

Comparative Analysis of the Effect of Acostream Catheter for Pulmonary Artery Thrombus Aspiration and Pulmonary Artery Catheterization and Thrombolysis in Patients with Pulmonary Embolism

作　　者：李积安 李尤 刘亚[2] 马强[1] 田红燕[1] LI Ji-an;LI You;LIU Ya;MA Qiang;TIAN Hong-yan(Department of Peripheral Vascular Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710061,China;Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710061,China)

机构地区：[1]西安交通大学第一附属医院周围血管科,陕西西安710061 [2]西安交通大学第一附属医院呼吸与危重症医学科,陕西西安710061

出　　处：《现代生物医学进展》2024年第24期4689-4691,共3页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(S2022-YF-ZDCXL-ZDLSF-0140)。

摘　　要：目的:探讨Acostream导管行肺动脉血栓抽吸术(ACTA)与肺动脉置管溶栓术(PACT)在中高危肺栓塞(PE)患者中的治疗效果。方法:选取2022.1-2024.3收治的90例中高危PE患者,分为ACTA组和PACT组,各45例。PACT组给予尿激酶肺动脉置管溶栓治疗,ACTA组给予Acostream导管行肺动脉血栓抽吸治疗。比较两组相关指标。结果:(1)ACTA组治疗总有效率高于PACT组(P=0.025)。(2)治疗后,ACTA组右心室大小、TR、PASP、PADP均较PACT组降低(P<0.05)。(3)治疗后,ACTA组与PACT组PaO_(2)较治疗前上升,PaCO_(2)下降,且ACTA组改善幅度大于PACT组(P<0.05)。两组治疗后血浆BNP和cTnI和D-二聚体水平均低于治疗前,且ACTA组下降更明显(P<0.05)。(4)ACTA组并发症发生率低于PACT组(P<0.05)。结论:对急性PE患者实施ACTA,可快速清除栓塞血管内血栓,恢复肺动脉血流,改善血气状态,疗效较优,且并发症风险低,安全性高。Objective:To compare and analyze the application effects of Acostream catheter-directed pulmonary artery thrombus aspiration(ACTA)and pulmonary artery catheter thrombolysis(PACT)in patients with pulmonary embolism(PE).Methods:90 intermediate and high-risk PE patients admitted to 2022.1-2024.3 were selected and divided into the ACTA group and the PACT group,with 45patients each.The PACT group was given urokinase pulmonary artery catheterization for thrombolysis,and the ACTA group was given a Acostream catheter for pulmonary artery thrombus aspiration.Compare the two groups of relevant indicators.Results:(1)The total response rate was higher in the ACTA group than in the PACT group(P=0.025).(2)After treatment,the RV size,TR,PASP,and PADP all decreased in the ACTA group compared with the PACT group(P<0.05).(3)After treatment,PaO_(2)increased in the ACTA and PACT groups compared with PaCO_(2)decreased before treatment,and the improvement in the ACTA group was greater than that in the PACT group(P<0.05).Plasma BNP and cTnI and D-dimer levels were lower after both treatment than before treatment,and the decrease was more pronounced in the ACTA group(P<0.05).(4)The complication rate was lower in the ACTA group than that in the PACT group(P<0.05).Conclusion:ACTA in patients with acute PE can quickly remove embolic vascular thrombosis,restore pulmonary artery blood flow,improve blood gas status,with excellent efficacy,low risk of complications and high safety.

关 键 词：Acostream导管 肺动脉血栓抽吸术 肺动脉置管溶栓术 肺栓塞 

分 类 号：R543.2[医药卫生—心血管疾病]