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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。
Objective To evaluate the efficacy of interventional treatment of acute pulmonary thromboembolism (PTE). Methods Seven patients with PTE who underwent pulmonary angiography to further clarify the embolization site were treated with interventional therapy (catheterization, thrombolysis, local thrombolysis and inferior vena cava filter placement) to observe clinical symptoms, pulmonary artery opening, PaO2, SaO2, and PAPm. Results The clinical symptoms of all PTE patients were significantly improved, and the rate of complete pulmonary artery opening was over 90%. The mean preoperative PAPm was 31 mmHg down to 25 mmHg postoperatively. The mean preoperative PaO2 54 mmHg increased to 95 mmHg postoperatively, with an average of 80% To 94% after surgery, no recurrence of PTE after surgery. Conclusion Interventional treatment of acute PTE can rapidly improve hemodynamics, reduce the right ventricular afterload and prevent the recurrence of PTE.