肺动脉内介入螺旋电吸式祛栓术治疗急性大面积肺栓塞

Intrapulmonary rotational power-driven thrombectomy therapy for acute massive pulmonary thromboembolism

目的探讨Straub螺旋电吸式祛栓术治疗急性大面积肺栓塞的效果和安全性。方法16例患者经cT及肺动脉造影确诊为大面积肺血管栓塞，均采用StraubRotarex进行经皮机械祛栓，观察患者介入治疗成功率、临床症状缓解及血流动力学变化情况。结果16例患者临床症状均得到改善。治疗前后动脉血氧分压[（56．7±13．4）、（92．2±8．6）mmHg]、动脉血氧饱和度[（84．1±10．4）％、（96．6±12．7）％]、休克指数[（1．27±0．39）、（0．57±0．42）]、Miller评分[（22．7±11．4）、（12．1±7．8）分]及平均动脉压[（36．3±9．4）、（21．9±7．3）mmHg]比较差异均有统计学意义（t值分别为-2．794、2．601、-2．592、-2．638、-2．617，P均〈0．01）。结论螺旋电吸式祛栓术在急性大面积肺栓塞治疗中具有较好的效果与安全性。

Objective To investigate the effect and safety of rotational power-driven thrombectomy therapy through intrapulmonary for acute massive pulmonary thromboembolism. Methods Sixteen patients of acute massive pulmonary thromboembolism diagnosed by CT and pulmonary angiography were treated with Straub Rotarex system. The successful rate, release of clinical manifestations and the blood hemodynamic changes were observed and analyzed. Results The clinical manifestations were improved remarkably in all the 16 patients, arterial partial pressure of oxygen, saturation of arterial blood oxygen, shock index , Miller score and mPAP were （56.7± 13.4） mm Hg, 84.1 ± 10.4）%, （1.27 ±0.39）, （22.7 ± 11.4） and （36.3 ±9.4） mm Hg respectively before treatment, and （92. 2 ± 8. 6） mm Hg, （ 96. 6 ± 12. 7 ） %, （ 0. 57 ± 0.42 ）, （ 12. 1 ± 7.8 ） points and （21.9 ± 7.3） mm Hg respectively after treatment, which were all improved significantly（ t = - 2. 794,2. 601, - 2. 592, - 2. 638, - 2. 617, P 〈 0. 01 ）. Conclusion Rotational power-driven thrombectomy therapy through intrapulmonary is an effective and safe technique for the treatment of acute massive pulmonary embolism.