急性肺栓塞二次溶栓治疗的疗效及安全性评价

Assessment of treatment effect and security of secondary thrombolytic therapy for patients with acute pulmonary embolism

目的评价急性肺栓塞二次溶栓治疗的疗效及安全性。方法回顾分析2002年7月～2010年10月在我院住院的12例需溶栓的急性肺栓塞病人,予重组组织型纤溶酶原激活剂(rt-PA)50 mg静脉输注,24小时后复查CT肺动脉造影(CT-PA)、心脏超声,血栓部分溶解且心脏超声示右心室室壁运动功能异常,再次予重组组织型纤溶酶原激活剂40 mg静脉输注行二次溶栓治疗。结果有效率100%。1例病人出现生殖道出血,无颅脑出血等危及生命的不良反应。结论急性肺栓塞首次予重组组织型纤溶酶原激活剂50 mg静脉溶栓,血栓部分溶解且心脏超声示右心室室壁运动功能异常者二次溶栓疗效确切,安全性好。

Objective To assess the treatment effect and security of secondary thrombolytic therapy for patients with acute pulmonary embolism. Methods Data of 12 patients with acute pulmonary embolism diagnosed in our hospital from July 2002 to October 2010 were retrospectively analyzed. First, each patient was given 50 mg recombinant tissue plasminogen activator（ rt-PA）, and then received computed tomography pulmonary angiography（CTPA） and Doppler echocardiography which showed that the thrombus was partly dissolved and right ventricular wall motion with abnormal function. And then they were given 40 mg rt-PA for the secondary thrombolytic therapy. Results The efficiency was 100%. Urogenital hemorrhage occurred in 1 patient. Vital side effect such as cerebral hemorrhage didn＇t appear. Conclusions Patients with acute pulmonary embolism whose thrombus were partly dissolved and right ventricular wall motion having abnormal function after initial 50 mg rt-PA,can receive secondary thrombolytic therapy,which showed good treatment effect and have safety.