急性肺血栓栓塞症的介入综合治疗

目的评价介入综合治疗急性肺血栓栓塞症(PTE)的疗效。方法7例PTE病人,经肺动脉造影进一步明确栓塞部位后,即采用介入综合治疗(经导管碎栓、抽吸取栓、局部溶栓及下腔静脉滤器置入),观察临床症状、肺动脉开通情况、动脉血氧分压(PaO2)、血氧饱和度(SaO2)、肺动脉平均压(PAPm)。结果所有PTE患者临床症状显著改善,肺动脉完全开通率90%以上;PAPm术前平均31 mmHg降至术后25 mmHg;PaO2术前平均54 mmHg升至术后95 mmHg,SaO2术前平均80%升至术后94%,术后未有再发PTE者。结论介入综合治疗急性PTE能够快速改善血液动力学,降低右心室后负荷,预防PTE复发。

Acute Pulmonary Thromboembolism :Interventional Comprehensive Treatment

Objective To evaluate the curative effect of interventional comprehensive therapy for pulmonary thromboembolism(PTE).Methods There were totally 7 patients with PTE,interventional comprehensive therapy including embolectomy and thrombolysis locally through catheter and inserting the inferior vena cave filter was performed after the embolic position defined by pulmonary artery angiography.The clinical symptoms,the openning of the lung artery PaO_2,SaO_2 and pulmonary arterial pressure(PAPm).Results The clinical symptoms were improved obviously in all cases,the openning rate completely of lung artery was more than 90%.The PAPm was 31 mmHg before operation and 25 mmHg after operation,the average level of PaO_2 rise from 54 mmHg before operation up to 95 mmHg after operation;the average level of SaO_2 rise from 80% before operation up to 94% after operation;there were no recurrent cases after operation.Conclusion To cure the acute PTE with interventional comprehensive treatment can improve the hemodynamics quickly,decrease the afterload of right ventricle and prevent the recurrence of PTE.