急性肺栓塞的腔内治疗效果观察

目的 观察急性肺栓塞的腔内治疗效果.方法 选择2009年1月至2011年6月我院收治的急性肺栓塞患者15例,采用经皮导管碎栓术及溶栓术治疗.局部灌注尿激酶,总量50万U;溶栓后给予低分子肝素钠7～10d,口服华法林钠3～6个月.观察临床症状和体征改善情况、并发症、平均肺动脉压（mPAP）与动脉血氧分压（PaO2）的变化,以及肺动脉开通情况.结果 12例肺动脉完全开通,3例部分开通,有效率100％（15/15）.mPAP较术前降低（40.07±5.97）、（20.00±4.66） mmHg],PaO2明显升高（50.26±9.30）、（80.49±9.04） mmHg],差异均有统计学意义（t值分别为-1.128和1.246,P均＜0.05）.随访3～6个月,疗效持续,未见复发.结论 急性肺栓塞介入治疗效果显著,安全可行.

Effect of intracavitary therapy on acute pulmonary embolism

Objective To explore the effect of intracavitary therapy on acute pulmonary embohsm.Methods Fifteen patients were selected as our subjects,who suffered acute pulmonary embolism and received percutaneous catheter thrombus crashing and catheter directed thrombolysis in Beijing Military.Region General Hospital from January 2009 to June 2011.Local injection of Urokinase was performed with a total amount of 500 000 U in catheter directed thrombolysis.After thrombolysis,low molecular Heparin was administered to patients for 7-10 days and oral administration of Warfarin was performed for 3-6 months.Clinical symptoms,improvement of physical signs,complications,changes of mean pulmonary arterial pressure（mPAP） and arterial partial pressure of oxygen（PO2）,and the opening of pulmonary artery were recorded.Results The pulmonary arteries of the 12 patients were completely opened,and partially opened in 3 patients.The effective rate was 100％ （15/15）.mPAP was reduced from （40.07 ±5.97） mmHg to （20.00 ±4.66） mmHg （t =-1.128,P ＜ 0.05）,PO2 was increased from （50.26 ± 9.30） mmHg to （80.49 ± 9.04） mmHg （t =1.246,P ＜ 0.05）.Patients were followed-up for 3-6 months and no recurrence case was seen.Conclusion The interventional therapy is effective,safe and practicable in the treatment of acute pulmonary embolism.