导管碎栓溶栓治疗肺动脉栓塞的临床应用分析

Analysis of the Clinical Application of Catheter Thrombolysis in the Treatment of Pulmonary Embolism

目的 探讨导管碎栓溶栓治疗高危肺动脉栓塞的疗效及安全性。方法 方便选取该院2011年11月—2015年12月收治的高危肺动脉栓塞患者44例,经肺动脉内导管碎栓和局部持续灌注尿激酶溶栓治疗,观察处理前后肺循环改善情况,分析心肺血流动力学的改变。结果 44例高危肺栓塞患者,术前心率、动脉血氧分压和血压分别为（120±26.86）次/min、（72±10.48）mm Hg和（88.12±10.86）mm Hg。术后分别为（81±7.84）次/min、（93.76±6.14）mm Hg和（130.22±14.16）mm Hg,与治疗前比较差异均有统计学意义（P〈0.05）。随访7-60个月,36例疗效持续,1例复发,3例因原发肿瘤死亡,4例失访。结论 肺动脉导管碎溶栓治疗对肺栓塞患者具有良好的改善作用,无明显并发症,是一种简单、安全、有效的方法,值得临床推广应用。

Objective To investigate the efficacy and safety of thrombolysis in the treatment of high risk pulmonary embolism. Methods Convenient selection our hospital in November 2011 to December 2015 high-risk patients with pulmonary embolism in 44 cases, the pulmonary artery catheter broken bolt and continuous infusion of local thrombolytic therapy with urokinase were observed before and after the treatment of the pulmonary circulation to improve the situation, analysis of changes in hemodynamics of heart and lung. Results 44 patients at high risk of pulmonary embolism patients, preoperative heart rate, arterial oxygen branch pressure and blood pressure were(120±26.86) beats/min,(72±10.48) mm Hg and(88.12±10.86) mm Hg. Postoperative respectively(81 ± 7.84) beats/min,(93.76±6.14) mm Hg and(130.22 ± 14.16) mm Hg, and before treatment differences were statistically significant(P < 0.05). Followed up for 7~60 months, 36 cases of curative effect, 1cases of recurrence, 3 cases of primary tumor death, 4 cases of loss of follow-up. Conclusion Pulmonary artery catheter fragmentation and thrombolysis in patients with pulmonary embolism has a good effect, no obvious complications, is a simple, safe and effective method, it is worth clinical application.