中危急性肺栓塞患者行肺动脉置管溶栓临床疗效观察

Clinical observation of catheter-directed thrombolysis for intermediate-risk acute pulmonary embolism

目的:探讨肺动脉置管溶栓在中危急性肺栓塞患者中的临床疗效。方法:回顾性分析2017年6月至2019年10月,16例行肺动脉置管溶栓治疗中危急性PTE患者的临床资料,对比溶栓前后患者呼吸频率、血氧饱和度、动脉血氧分压、心率、D-二聚体及肺动脉DSA、CTA结果,评估治疗效果。结果:16例肺栓塞患者均顺利完成肺动脉置管溶栓治疗。其中14例患者因合并下肢DVT同期行下腔静脉滤器置入,术后1周内14例患者临床症状均消失,呼吸频率、血氧饱和度、动脉血氧分压、心率、D-二聚体较术前明显改善;肺动脉DSA复查未见血栓残留,术后无严重并发症发生,治愈率87.5%。术后3个月16例患者肺动脉CTA复查未见血栓残留,治愈率达100%。结论:肺动脉置管溶栓可有效缓解中危急性肺栓塞患者临床症状,临床疗效确切。

Objective:To investigate the clinical observation of catheter-directed thrombolysis for intermediate-risk acute pulmonary embolism.Methods:Retrospective analysis of clinical data of 16 patients with intermediate-risk acute PTE treated in our hospital from June 2017 to October 2019,and treated with pulmonary artery catheter-directed thrombolysis,and compared the respiratory frequency and blood oxygen saturation of patients,Arterial oxygen pressure,heart rate,D-dimer and pulmonary arterial DSA,CTA re-examination results to evaluate the treatment effect.Results:Pulmonary artery thrombolysis was successfully completed in 16 patients with pulmonary embolism.Among them,14 patients underwent inferior vena cava filter at the same time because of lower limb DVT.The clinical symptoms of 14 patients disappeared within 1 week after operation.Respiratory frequency,blood oxygen Saturation,partial pressure of arterial oxygen,heart rate,and D-dimer were significantly improved compared with those before surgery,and the differences were statistically significant(P<0.05).No thrombotic residues were found in the re-examination of the DSA in the pulmonary artery,and no serious complications occurred after the operation.The rate was 87.5%;no pulmonary thrombus was found in the CTA of 16 patients at 3 months after operation,and the cure rate was 100%.Conclusion:Catheter-directed thrombolysis can effectively relieve the clinical symptoms of patients with intermediate-risk acute pulmonary embolism.