导管导向溶栓与导管导向取栓术治疗高危肺栓塞的疗效比较

To compare the clinical efficacy of catheter-guided thrombolysis and catheter-guided thrombectomy in the treatment of high-risk pulmonary embolism

目的比较导管导向溶栓与导管导向取栓术治疗高危肺栓塞的疗效。方法回顾性分析2020年4月至2023年1月河北中石油中心医院105例高危肺栓塞患者的临床资料。其中,采用导管导向溶栓治疗52例(溶栓组),导管导向取栓术治疗53例(取栓组)。比较两组疗效、症状缓解时间、血氧饱和度恢复时间、病死率、Qanadli栓塞指数、肺动脉压力和并发症。结果两组总有效率、症状缓解时间、血氧饱和度恢复时间、病死率和总并发症发生率比较差异无统计学意义(P>0.05)。溶栓组和取栓组治疗后Qanadli栓塞指数和肺动脉压力明显低于治疗前[溶栓组:22.08±8.57比45.18±13.27和(24.18±5.19)mmHg(1 mmHg=0.133 kPa)比(34.15±6.22)mmHg,取栓组:23.11±8.62比44.82±13.14和(23.66±5.02)mmHg比(34.89±6.27)mmHg],差异有统计学意义(P<0.01);两组治疗前后Qanadli栓塞指数和肺动脉压力比较差异无统计学意义(P>0.05)。结论在高危肺栓塞患者中,导管导向溶栓和导管导向取栓术均具有良好的疗效,能促进临床症状缓解和血氧饱和度恢复,改善预后。

Objective To compare the efficacy of catheter-directed thrombolysis versus catheter-directed thrombectomy for high-risk pulmonary embolism.Methods The clinical data of 105 patients with high-risk pulmonary embolism from April 2020 to January 2023 in Hebei China Petroleum Central Hospital were retrospectively analyzed.Among them,52 patients were treated with catheter-directed thrombolysis(thrombolysis group),and 53 patients were treated with catheter-directed thrombectomy(thrombectomy group).The efficacy,symptom relief time,oxygen saturation recovery time,mortality rate,Qanadli embolic index,pulmonary artery pressure and complications were compared between two groups.Results There were no statistical differences in total effective rate,symptom relief time,oxygen saturation recovery time,mortality rate and total incidence of complications between two groups(P>0.05).Compared with before treatment,the Qanadli embolic index and pulmonary artery pressure after treatment in thrombolysis group and thrombectomy group were significantly lower,thrombolysis group:22.08±8.57 vs.45.18±13.27 and(24.18±5.19)mmHg(1 mmHg=0.133 kPa)vs.(34.15±6.22)mmHg,thrombectomy group:23.11±8.62 vs.44.82±13.14 and(23.66±5.02)mmHg vs.(34.89±6.27)mmHg,and there were statistical differences(P<0.01);but there was no statistical difference the Qanadli embolic index and pulmonary artery pressure before and after treatment between two groups(P>0.05).Conclusions In patients with high-risk pulmonary embolism,both catheter-directed thrombolysis and catheter-directed thrombectomy have good efficacy and can promote the relief of clinical symptoms and the recovery of oxygen saturation,improving the prognosis.