| 超声辅助导管溶栓在肺血栓栓塞症中的应用进展 |
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| 引用本文： | 张毅,罗勤,赵智慧,赵青,柳志红. 超声辅助导管溶栓在肺血栓栓塞症中的应用进展[J]. 协和医学杂志, 2022, 13(1): 104-109. DOI: 10.12290/xhyxzz.2021-0029 |
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| 作者姓名： | 张毅 罗勤 赵智慧 赵青 柳志红 |
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| 作者单位： | 国家心血管病中心 中国医学科学院阜外医院呼吸与肺血管疾病疹治中心，北京 100037 |
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| 基金项目： | 北京市自然科学基金7202168中国医学科学院医学与健康科技创新工程2020-I2M-C & T-B-055 |
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| 摘 要： | 肺血栓栓塞症(pulmonary thromboembolism, PTE)是心血管疾病中导致患者死亡的第三大常见原因。在真实世界中,因担心出现大出血等风险,仅20%～30%的高危PTE患者接受了系统性溶栓治疗,虽然中危PTE患者接受系统性溶栓可降低死亡率,但出血风险远高于获益。超声辅助导管溶栓可在血栓部位直接释放溶栓药物,所需药物剂量更低,且超声波可促进血栓溶解,有望成为一种安全、有效的溶栓新手段。本文将介绍超声辅助导管溶栓的机制、所需设备与操作程序、安全性与有效性等,并对未来的研究方向提出展望。
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| 关 键 词： | 肺血栓栓塞症 溶栓治疗 超声波 |
| 收稿时间： | 2021-01-09 |
Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism |
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| Affiliation: | Center for Respiratory and Pulmonary Vascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Disease, Beijing 100037, China |
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| Abstract: | Pulmonary thromboembolism(PTE)is the third most common cause of cardiovascular death. However, only about 20% to 30% of patients with high-risk PTE received systemic thrombolysis in real world, due to concerns about the risks such as major bleeding. Although systemic thrombolysis could decrease all-cause mortality of patients with intermediate-risk PTE, the risk of bleeding outweighs the benefits. Ultrasound-assisted catheter-directed thrombolysis (UA-CDT) could directly deliver thrombolytic drugs to the thrombus with lower doses needed. Meanwhile, ultrasound waves could also enhance thrombolysis. Therefore, UA-CDT is emerging as a new tool, with good efficacy and safety records, for the treatment of PTE. In the present review article, we introduce the mechanism, required device, common protocol, efficacy and safety of UA-CDT and discuss directions for future studies. |
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