肺动脉栓塞不同分型栓子溶栓治疗前后CT对照

CT Comparative Study in Different Type Embolism of Pulmonary Embolism before and after Thrombolytic Therapy

目的利用螺旋CT肺动脉血管造影(CTPA)对比分析肺动脉栓塞(PE)不同分型栓子溶栓治疗效果。方法分析30例187支肺动脉栓塞,将栓子分为四型:中心型(79支)、附壁凸起型(34支)、附壁凹陷型(18支)和完全充盈型(56支)。观察溶栓治疗前后相对应受累肺动脉分支,对比不同栓子分型的溶栓治疗效果。结果附壁凹陷型溶栓治疗效果有效率为(27.8%)较中心型、附壁凸起型和完全充盈型差(有效率分别为84.8%、79.4%、66.1%)(均P<0.05)。结论明确不同分型栓子与溶栓治疗效果的关系,能为PE临床治疗方案的选择和调整提供依据。

Objective To analyze the effect of thrombolytic therapy on different type embolism of pulmonary embolism using multi-detector CT pulmonary angiography （CTPA）.Methods Among 30 patients with 187 pulmonary embolisms,according to the shape of pulmonary artery opacification,the vascular signs of pulmonary embolism were classified as the follows：central intraluminal filling defect（n=79）,mural filling defect with protrusive margin（n=34）,mural filling defect with pitting margin（n=18）,and complete filling defect（n=56）.Observed the same pulmonary artery before and after thrombolytic therapy and analyzed the effect of thrombolytic therapy on different type embolism.Results Therapeutic efficacy of mural filling defect with pitting margin（27.8%）was lower than that of central intraluminal filling defect（84.8%）,mural filling defect with protrusive margin（79.4%）and complete filling defect（66.1%）.There were statistical differences（all P0.05）.Conclusion To define the relation between different type embolism and effect of thrombolytic therapy could provide basis for clinician choice and adjustment rightly.