伴有心搏骤停疑诊肺血栓栓塞症患者溶栓治疗的效果评价

Effects of thrombolytic therapy in patients with cardiac arrest from suspected pulmonary thromboembolism

目的 评价对伴有心搏骤停疑诊肺血栓栓塞症（PTE）患者进行重组组织型纤溶酶原激活剂（rt-PA）溶栓的疗效.方法 回顾性分析2010年1月至2014年6月在北京朝阳医院所有住院患者中伴有心搏骤停高度怀疑PTE,并且在心肺复苏过程中进行rt-PA 50 mg静脉溶栓的12例患者的临床资料,记录其一般资料,并对其溶栓的有效性、安全性及预后进行分析.结果 12例患者中,男6例,女6例,年龄16～81岁,平均（54.8±18.6）岁.外科住院患者7例,围手术期患者6例.溶栓前复苏时间17 ～ 90 min,平均（47.8±26.0）min.9例恢复自主循环,自主循环恢复时间5～20min,平均（15.8±5.4）min,24 h生存8例.溶栓后存在出血并发症4例,其中危及生命的2例,出院长期生存患者4例.结论 对伴有心搏骤停疑诊PTE患者进行rt-PA 50 mg溶栓治疗,有利于自主循环恢复,提高24 h生存率.

Objective To explore the effects of thrombolytic therapy with recombinant tissue-type plasminogen activator （rt-PA） in patients with cardiac arrest from suspected pulmonary thromboembolism （PTE）.Methods A total of 12 hospitalized patients with cardiac arrest from suspected pulmonary embolism at Beijing Chaoyang Hospital from January 2010 to June 2014 were retrospectively studied.Thrombolysis was given only as a single dose of 50 mg of rt-PA during cardiopulmonary resuscitation.And their clinical features,effocacies and outcomes of thrombolysis were analyzed.Results There were 6 males and 6 females with a mean age of （54.8-± 18.6）（16-81） years.Seven patients were hospitalized in surgery ward while another 6 perioperatively.The mean time of resuscitation before thrombolysis was （47.8 ± 26.0） （17-90） min.Nine patients regained spontaneous circulation.The mean time of restored spontaneous circulation was （15.8 ± 5.4） （5-20）.The 24-hour survival rate was 8/12.Four patients had bleeding complications,but only 2 life-threatening major cases.Four patients obtained a long-term survival.Conclusion For suspected PTE patients with sudden cardiac arrest,thrombolysis therapy with 50 mg of rt-PA may restore spontaneous circulation and boost 24-hour survival rate.