血管内介入治疗急性肺栓塞疗效观察

目的:研究经皮血管内介入治疗肺栓塞的临床价值。方法:21例临床疑诊病例,经多层螺旋CT或心脏彩超诊断为大面积或次大面积肺栓塞后,立即接受经皮肺动脉内导管碎栓及溶栓治疗。观察肺循环和临床症状改善情况。18例同时合并有下肢深静脉血栓患者,溶栓治疗后放置下腔静脉滤器。结果:20例患者临床症状明显改善。1例改善不明显。治疗前平均肺动脉压(36±5)mmHg、动脉血氧分压(32±6)mmHg,溶栓治疗后分别为(20±3)mmHg、(66±4)mmHg,前后比较有统计学意义(P<0.05)。结论:血管内介入治疗急性大面积或次大面积肺栓塞安全、有效。

Observation on efficacy of endovascular therapy for acute pulmonary embolism

Objective：To evaluate the clinical effect of percutaneous endovascular therapy for acute pulmonary embolism. Methods：21 suspected cases were accepted intrapulmonary fragmentation of thrombus using catheter and contact thrombol- ysis with urokinase or rt-PA after diagnosed for massive or in-massive pulmonary embolism by multi-slice CT and heart color Doppler ultrasound. The changes of pulmonary circulation as well as clinical manifestations before and after treat- ment were compared. Inferior vena cava filters were placed in 18 cases with lower extremity deep venous thrombosis. Re- suits： Significant improvement of clinical symptoms was observed in 20 cases after the procedure without one patient. Mean pulmonary arterial pressure were from （36±5） mmHg to （20±3） mmHg, arterial partial pressure of oxygen were from （32±6） mmHg to （66±4） mmHg （ P d0.05）. Conclusi0n：The endovascular interventional therapy is safe and effective for the treatment of acute massive or in-massive pulmonary embolism.