经导管祛栓术治疗急性肺动脉栓塞

Pulmonary embolectomy by catheter to treat acute pulmonary embolism

目的 探讨经导管栓子祛除术治疗急性肺动脉栓塞的临床疗效。方法 对 2 4例急性肺动脉栓塞的病人 ,经肺动脉造影明确诊断 ,通过旋转猪尾导管碎栓、抽吸导管抽吸和局部溶栓来开通肺动脉。观察临床症状、动脉血氧分压 (PaO2 )、肺动脉平均压 (PAPm)和肺动脉开通情况。结果 术后症状即刻缓解者 2 3例 ,完全开通者 2 0例 ,与术前相比PaO2 明显升高 (P <0 0 5 ) ,PAPm明显降低(P <0 0 5 ) ,并发脑出血 1例 ,死亡 2例 ,2 2例病人存活。

Objective To evaluate the effectiveness of pulmonary embolectomy by catheter for the treatment of acute pulmonary embolism. Methods Twenty four cases were diagnosed as pulmonary embolism by pulmonary angiography, then treated with thrombus fragmentation and suction by catheters, and local fibrinolysis. The symptoms, PaO 2, PAPm , and pulmonary arteries were observed after the procedure. Results Twenty two patients survived and showed clinical improvement with resultant significant ( P <0.05) decrease in PAPm and increase in PaO 2. Mortality was in 2 patients. Conclusion Pulmonary embolectomy by catheter is a safe and reliable procedure in treating the acute pulmonary embolism.