Angiojet抽栓装置对急性中危肺栓塞的治疗价值

The Value of Angiojet Thrombectomy in the Treatment of Acute Intermediate-Risk Pulmonary Embolism

目的探讨Angiojet抽栓装置治疗急性中危肺栓塞患者有效性和安全性。方法搜集20例急性中危肺栓塞患者,均通过Angiojet行抽栓治疗。比较抽栓前后Miller指数(MI),右、左心室内径比(RV/LV),平均肺动脉压(MPAP)及动脉氧分压(PaO_(2)),并观察术后患者是否发生呼吸困难、出血、再发肺栓塞等情况。结果抽栓前后MI由16.95±2.37降至8.55±1.90(P<0.05),RV/LV由0.51±0.13降至0.37±0.04(P<0.05),MPAP由34.31±9.98降至24.06±4.20(P<0.05),PaO_(2)由术前72.36±7.34升至92.24±4.62(P<0.05)。术后2例患者发生呼吸困难,1例经插管机械通气、1例经激素冲击增加氧流量后缓解。1例患者出现少尿,转至ICU予以保守治疗,后缓解。所有患者均观察至出院,无出现死亡、大出血等患者,随访时间3~6个月,随访期间内无再发肺栓塞相关症状,复查CTA示肺动脉血栓减少或消失。结论对于中危肺栓塞患者,Angiojet抽栓治疗是一种安全、有效的治疗方法。

Objective To investigate the efficacy and safety of Angiojet thrombectomy in patients with acute intermediate-risk pulmonary embolism. Methods 20 patients with acute intermediate-risk pulmonary embolism underwent Angiojet thrombectomy.Miller index(MI),right and left ventricular diameter ratio(RV/LV),mean pulmonary artery pressure(MPAP) and arterial partial pressure of oxygen(PaO_(2)) were compared before and after thrombectomy, and observe whether the patient has dyspnea, bleeding, and Pulmonary embolism after operation. Results MI decreased from 16.95±2.37 to 8.55±1.90(P<0.05),RV/LV decreased from 0.51±0.13 to 0.37±0.04(P<0.05),MPAP decreased from 34.31±9.98 to 24.06±4.20(P<0.05),PaO_(2) increased from 72.36±7.34 to 92.24±4.62(P<0.05).Dyspnea occurred in 2 patients after operation, 1 patient was relieved after intubation and mechanical ventilation, and 1 patient was relieved after increasing oxygen flow by hormone shock.One patient developed oliguria and was transferred to ICU for conservative treatment. Conclusion For patients with intermediate-risk pulmonary embolism, Angiojet thrombectomy is a safe and effective treatment.