肺动脉留置导管溶栓治疗急性肺栓塞37例体会

37 Cases of Pulmonary Indwelling Cacheter Thrombolytic Therapy for Acute Pulmonary Embolism

目的:探讨肺栓塞患者的临床表现、诊断和肺动脉留置导管溶栓治疗效果。方法:对37例肺动脉置管溶栓治疗肺栓塞患者完整资料进行回顾性分析。结果:95%的患者伴下肢深静脉血栓,具有呼吸困难者32例,胸痛23例,咯血者仅9例,92%的患者存在低氧血症,47%的患者同型半胱氨酸升高,所有患者经64排螺旋CT肺动脉增强扫描明确诊断,放置滤器后留置肺动脉导管溶栓治疗7～10 d,复查CT进行比对,有效100%,显效67.6%,无1例死亡。结论:肺栓塞主要症状为呼吸困难和胸痛,体征以呼吸增快、口唇发绀等为主;其最常见诱因为下肢深静脉血栓形成,行64排螺旋CT肺动脉增强扫描能够明确诊断,放置下腔静脉滤器后留置肺动脉导管溶栓治疗,疗效确切。

Objective： To investigate the clinical manifestations, diagnosis, and effects in pulmonary artery indwelling catheter thrombolysis treatment of patients with pulmonary embolism. Methods：Complete data of 37 patients with pulmonary artery catheter thrombolytic therapy for pulmonary embolism were retrospectively ana- lyzed. Results： 95 % of patients with deep venous thrombosis, 32 cases with difficulty in breathing, 23 cases with chest pain, only 9 cases with hemoptysis, 92 % of patients with hypoxemia, 47 % of patients with elevated homocysteine. All patients were confirmed the diagnosis by 64 - row spiral CT pulmonary enhahced scan, and placed the filters. After indwelling pulmonary artery catheter thrombolysis therapy 7 to 10 days, CT scan for comparison showed 100 % of patients were effective, 67.6 % significant effective, with no deaths. Conclusion： The main symptoms of pulmonary embolism are difficulty breathing and chest pain, signs are of tachypnea and lips cyanosis; its most common predisposing factor is deep venous thrombosis formation. The diagnosis can be conformed by 64 - row spiral CT pulmonary enhanced scan. Placing the inferior vena cava filter and indwelling pulmonary artery catheter thrombolytic therapy are exactly effective.