腔内治疗急性大面积肺动脉栓塞的临床疗效

目的探讨急性大面积肺动脉栓塞腔内治疗的安全性及有效性。 方法回顾性分析2014年10月至2018年6月山东第一医科大学附属省立医院和济南市中医医院收治的49例接受腔内治疗的急性大面积肺动脉栓塞患者的临床资料,其中男性32例,女性17例;年龄22～55岁,平均(36±8.18)岁。对所有大面积肺栓塞患者急诊行下腔静脉滤器植入、肺动脉置管溶栓、机械碎栓、导管吸栓等腔内治疗,观察患者临床症状改善情况,对照治疗前后患者肺动脉高压和Miller评分,评价腔内治疗急性大面积肺动脉栓塞的效果。 结果47例患者(47/49,95.92%)呼吸困难、胸闷、胸痛、咳嗽、咯血等症状好转,肺动脉压、血氧饱和度、血氧分压及Miller评分显著改善(P<0.05),2例患者(2/49,4.08%)症状改善不明显。 结论急性大面积肺动脉栓塞的腔内治疗可以恢复肺灌流量,效果显著。

Clinical efficacy ofinterventional therapy of acute massive pulmonary embolism

ObjectiveTo investigate the safety and efficacy of interventional therapy of acute massive pulmonary embolism. MethodsClinical data of 49 patients with acute massive pulmonary embolism who were treated in Provincial Hospital affiliated to Shandong First Medical University and Jinan Municipal Hospital of Traditional Chinese Medicine form October 2014 to June 2018 were analyzed retrospectively. Among them, 32 were male and 17 were female, the age was 22 to 55 years, and the mean age was (36±8.18) years. All patients with acute massive pulmonary embolism were treated with inferior vena cava filter implantation, pulmonary artery catheter directed thrombolysis, mechanical thrombus breakage, catheter thrombus suction and so on, and the effect of interventional therapy of acute massive pulmonary embolism was evaluated by observing the improvement of the patients’ clinical symptoms and comparing pre- and post-operative pulmonary hypertension and Miller score. ResultsIn 47 patients (47/49, 95.92%), the symptoms of dyspnea, chest tightness, chest pain, cough and hemoptysis were improved, and pulmonary artery pressure, oxygen saturation, partial pressure of oxygen and Miller score were significantly increased (P<0.05). Two patients (2/49, 4.08%) showed no significant improvement in symptoms. ConclusionThe interventional therapy of acute massive pulmonary embolism could recover the pulmonary perfusion flow with significant effect.