介入机械性血栓清除术治疗急性肺栓塞

目的探讨应用介入机械性血栓清除术治疗急性肺栓塞的方法、疗效和安全性。方法对26例急性肺栓塞患者,行肺动脉造影明确栓子部位,应用机械血栓清除器械(Amplatz血栓消融器17例,Straub血栓旋切器9例)行介入血栓清除术,观察临床症状、肺动脉血栓清除情况、血氧饱和度(SaO2)、肺动脉平均压(MPAP)、动脉血氧分压(PaO2)。25例明确伴下肢深静脉血栓形成者,介入血栓清除术后放置下腔静脉滤器。结果本组均成功行介入机械性血栓清除术,26例患者介入术后临床症状均明显改善,SaO2明显上升,MPAP明显下降,PaO2明显升高,21例肺动脉内血栓大部分清除,无严重手术相关并发症。术后随访1～36个月,患者无肺动脉栓塞复发。结论介入机械性血栓清除术治疗急性肺栓塞是创伤小、安全易行、疗效确切的治疗方法。

Interventional mechanical thromboctomy for acute pulmonary embolism

Objective To evaluate the method,efficacy and safety of interventional mechanical thrombectomy in the treatment of acute pulmonary embolism.Methods 26 patients were diagnosed as acute pulmonary embolism by pulmonary angiography and treated by mechanical thrombectomy device.The Amplatz thrombectomy device was used in 17 cases,and the Straub rotarex system was performed in 9 cases.The clinical symptoms,pulmonary arterial recanalization,blood oxygen saturation,MPAP and PaO2 were observed before and after the procedure.Inferior vena cava filters were placed in 25 cases with lower extremity deep venous thrombosis.Results The interventional mechanical thrombectomy was enforced successfully in 26 cases with significant improvement of clinical symptoms after the procedures.The blood oxygen saturation and PaO2 showed significantl increase and MPAP was decrease.Most thrombi in the pulmonary artery were cleared out in 21 cases.No significant complications occurred in all patients.During 1 to 36 months follow-up,no recurrence of PE occurred.Conclusions The interventional mechanical thrombectomy for the treatment of acute pulmonary embolism is a safe,easy and effective method.