肺栓塞介入治疗的临床观察

Clinical Study on the Interventional Treatment of Acute Pulmonary Embolism

目的总结经皮介入溶栓治疗肺栓塞的疗效。方法经DSA确诊,并行介入治疗肺栓塞12例,采用普通造影导管,局部灌注加即刻全身应用尿激酶,总量约100万单位,在溶栓后12h,给与低分子肝素7～10d,口服华法林3～6个月,疗效判定依据临床症状,平均肺动脉压,血氧分压,D-二聚体。结果所有患者均获得显著疗效,平均肺动脉压从39.33±7.73mmHg到20.00±4.26mmHg(P<0.01),动脉血氧分压从48.67±10.60mmHg到78.75±9.84mmHg(P<0.01)。结论经皮局部灌注溶栓加全身应用尿激酶治疗肺栓塞安全有效,可显著改善临床症状。

Objective To evaluate the effect of per cutem interventional procedures in the treatment of acute pulmonary embolism.Methods Patients with acute pulmonary embolism were diagnosticed by DSA and immediately received interventional treatment （12 cases） The patients were treated with common radiography vessels, Urokinase were regional perfused and general used for the total of 1 million units. 12 hours after thrombolysis,they received low molecular heparin therapy for 7 to 10 days,then they took warfarin orally for 3 to 6 months.Effectiveness judgemen tdepended on clinic symptoms,lateral pressure of pulmonary artery,partial pressure of blood oxygen and D-dimer.Results The treatment gained predominance effect in all cases,the average pressure of pulmonary artery were from 39.33 ±7.33 mmHg to 20.00 ± 4.26mmHg （P〈0.01）,partial pressure of blood oxygen were from 48.67 ± 10.06 mmHg to 78.75 ±9.84mmHg（P〈0.01）. Conclusion The treatment of per cutem reginal perfusion and thrombolysis, Urokinase general using is a safe and effective method for treating pulmonary embolism and can significantly improve clinic symptoms of the patients.