摘要
目的:肺血栓栓塞的栓子如未被完全溶解,则可发展成肺动脉高压、肺原性心脏病(肺心病),最终死于右心衰竭或呼吸衰竭。本文拟探讨此病的诊治。方法:1988年 ̄1994年期间,21例病人经肺核素通气灌注扫描和(或)肺动脉造影检查证实为慢性肺血栓栓塞。对其中15例使用了尿激酶(5×10^5U,于20分钟内静脉滴注)和蝮蛇抗栓酶(1U/d,静脉滴注14天)治疗,对治疗无效者中的1例进行了肺血栓内膜剥脱术。
Objective: If the emboli of pulmonary thromboembolism have not been lysed completely,pulmonary hypertension and pulmonary heart disease, even heart failure or respiratory failure may develop due to chronic pulmonary thromboembolism. The aim of this paper is to explore the diagnosis and treatment of this disease entity. Methods: Twenty-one patients were diagnosed as chronic pulmonary thromboembolism by both ventilation and perfusion radionuclide scans and pulmonary arteriograms during 1988—1994. Fifteen of them were treated first with urokinase (5×10~5 U, iv drip within 20 min)and then ahylysantinfarctase (1U/d,iv drip for 14 days),and pulmonary thromboendarterectomy was performed on one of the ineffective patients. Results: The emboli in 4 of the 15 patients were partly lysed,inereased in 8 patients and had no change in 3. The operated patient recovered well, heart function improved from class Ⅳ (NYHA) at admission to class Ⅱ at discharge from the hospital,and to class Ⅰ after two years. Conclusion: Treatment by urokinase and ahylysantinfarctase can not completely lyse the emboli and prevent the formation of emboli. Pulmonary thromboendarterectomy can obviously improve the symptoms, signs and prognosis of the patient.
出处
《中国循环杂志》
CSCD
1996年第6期350-353,共4页
Chinese Circulation Journal
关键词
肺血栓
溶栓术
内膜剥脱术
Thromboembolism
Thrombolytie treatment
Thromboendarterectomy