手术后并发急性大面积肺血栓栓塞患者溶栓治疗的效果

Effect of thrombolysis in patients complicated with acute massive pulmonary embolism after surgical operation

目的:了解手术后发生急性大面积肺血栓栓塞患者进行静脉溶栓治疗的安全性及经验。方法:收集我科5例手术后6 d内发生急性大面积肺血栓栓塞患者的临床资料,在评估其出血风险后给予阿替普酶50 mg缓慢静脉溶栓治疗,观察治疗后患者症状、生命体征和临床指标及出血情况。结果:5例患者均接受了静脉溶栓治疗,其症状和临床指标均明显好转出院,未见溶栓后手术伤口大出血及其他危险情况。仅有1例患者出现伤口处出血,在停用溶栓药物,加强对症处理后好转。结论:对于手术后近期急性大面积肺血栓栓塞患者,在评估其总体出血风险较低后,可在严密监测下进行溶栓治疗,能改善患者预后,不增加患者大出血的风险。

Objective：To investigate the effect and safety of thrombolysis in treatment of patients with acute massive pulmonary embolism （AMPE） after surgical operation.Methods：Clinical data of 5 patients with AMPE within 6 days after surgical operation were collected,the bleeding risk was evaluated and then 50mg ateplase infusion was then given with low speed.The symptoms,vital signs and other clinical conditions were re-evaluated and bleeding events were monitored.Results：The clinical conditions were obviously improved after thrombolysis in 5 patients.Neither major bleeding nor other adverse events was observed.Only one patient suffered from a moderate wound bleeding,which was controlled after alteplase infusion was discontinued.Conclusions：For patients with AMPE after surgical operation,the bleeding risk should be evaluated,the thrombolytic agents can still be applied under close monitoring which can improve the patients＇prognosis without increase of major bleeding event.