手术治疗肺动脉栓塞12例临床分析

Surgical therapy of 12 cases with pulmonary embolism

目的探讨肺动脉栓塞症(PTE)的围手术期处理原则。方法回顾性分析外科治疗的12例肺动脉不同来源的栓子栓塞患者的临床资料。结果慢性PTE9例,围手术期死亡1例;急性PTE1例;肺动脉瘤性栓塞2例,术中死亡1例。除2例术中死亡外,其他患者术后近期恢复良好,心功能有不同程度的改善。结论对于各种肺动脉栓塞患者,加强围手术期处理,严格掌握手术的适应证,及时防治术中和术后的肺再灌注损伤和肺动脉高压,防止再栓塞,可取得较好疗效。

Objective To discuss the principle of perioperative management of pulmonary embolism. Methods A retrospective study of 12 patients with pulmonary embolism by emboli from multi-origins and received surgical management was taken. Results There were 9 patients of chronic pulmonary thromboembolism （FIE） with 1 perioperative death, 1 patient of acute pulmonary thromboembolism, 2 patients of pulmonary embolism by tumor of embolus with 1 perioperative death. Except the 2 perioperative deaths, the other 10 patients had recovered well and their heart function had improved to different degree. Conclusions For patients of pulmonary embolism by emboli from different origins, perioperative management are important for effective surgical treatment. The indication should be selected strictly. Proper management of pulmonary reperfusion injury, pulmonary hypertension and re-embolism prevention perioperatively are key factors for successful operation.