Amplatz血栓消融术治疗大块肺栓塞——附2例报告  

Clinical Application of the Amplatz thrombectomy device in massive pulmonary embolism

作　　者：柳志红[1] 赵彦芬[1] 倪新海[1] 陈白屏[1] 高润霖[2] 杨跃进[2] 戴汝平[3] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院心脏肺循环研究室,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室,北京100037 [3]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京100037

出　　处：《中国微创外科杂志》2001年第6期371-372,F002,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨Amplatz血栓消融器治疗大块肺栓塞 (PE)的可行性。　方法　对 2例年轻男性经溶栓无效或贻误有效溶栓时机的大块PE患者行Amplatz血栓消融术。　结果　术后肺血流灌注亚急性PE患者明显改善 ,慢性PE再发患者略有改善。前者PaO2 由术前 5 3.8mmHg升至 6 7.3mmHg,2个月后升至 80 .0mmHg。 7个月后核素肺灌注显像大致正常。后者术中症状明显减轻 ,术后PaO2 由 6 6 .4mmHg升至 83 .6mmHg。 3个月后 ,肺动脉压由 5 3.5mmHg降至 2 4mmHg。仅 1例术中轻微左侧胸痛。　结论　对大块亚急性PE患者实施Amplatz血栓消融术技术上可行 ,但需进一步评价。Ojective To evaluate the feasibility of Amplatz thrombectomy device for the treatment of massive pulmonary embolism(PE). Methods Mechanical thrombectomy with ATD was performed in 2 male patients with subacute or recurrent chronic PE. Results Marked improvement in pulmonary perfusion was observed in a patient with subacute PE,whose P aO 2 increased from 53.8mmHg to 67.3mmHg, then to 80mmHg after 2 months. After 7 months the nuclear lung perfusion scan was almost normal. The other patient described improvement in his breathing during the procedure. P aO 2 increased from 66.4 mmHg to 83.6mmHg after operation. 3 months later, the systolic pulmonary aterial pressure decreased from 53.5mmHg to 24mmHg. Only One patient developed mild left chest pain. Conclusions Mechanical thrombectomy with the ATD in patients with subacute massive PE is technically feasible,but need more clinical practice.

关 键 词：血栓消融术 大块肺栓塞 AMPLATZ血栓消融器 肺血流灌注 血液动力学 介入治疗 

分 类 号：R815[医药卫生—放射医学]