下腔静脉临时滤网联合导管接触溶栓治疗盆腔源性急性肺栓塞

Temporary inferior vena cava filter combined with catheter contact thrombolysis in the treatment of acute pulmonary embolism secondary to pelvic vein thrombosis

目的 探讨盆腔源性急性肺栓塞(APE)的治疗方法及疗效。方法 回顾性分析长沙市第一医院感染性疾病治疗中心2020年至2021年收治的8例盆腔源性APE患者的诊疗情况,所有患者均采用下腔静脉临时滤网联合导管接触溶栓治疗,3个月后随访了解患者的预后。结果 治疗后患者动脉血氧分压由(52.83±4.18)mmHg增加至(92.34±6.12)mmHg (t=33.221,P<0.01),血氧饱和度由(80.83±5.34)%增加至(96.12±4.11)%(t=13.853,P<0.01);休克指数、Miller评分明显降低(P<0.05)。所有患者均康复出院,平均住院日17.5 d,下腔静脉临时滤网回收率100%,回收平均时间3.38周,3个月后肺动脉CT动脉血管成像提示肺动脉主干通畅率100%。结论 下腔静脉临时滤网联合导管接触溶栓治疗盆腔源性APE安全有效。

Objective To investigate the treatment methods and efficacy of acute pulmonary embolism.Methods The diagnosis and treatment information of 8 patients with APE secondary to pelvic vein thrombosis admitted by the Changsha First Hospital from 2020 to 2021 were recorded and analyzed.All patients treated with temporary inferior vena cava filter combined with catheter contact thrombolysis.The prognosis was analyzed after the 3-month follow-up.Results After treatment,Arterial partial pressure of oxygen increased from(52.83±4.18) mmHg to(92.34±6.12) mmHg(t=33.221,P<0.01),and blood oxygen saturation increased from(80.83±5.34)% to(96.12±4.11)%(t=13.853,P<0.01).The shock index and Miller's score significantly decreased.All patients recovered and were discharged,with an average hospital stay of 17.5 days.The recovery rate of the temporary inferior vena cava filter was 100%,with an average recovery time of 3.38 weeks.After 3 months,pulmonary artery CTA showed a 100% patency rate of the pulmonary artery tunk.Conclusion The combination of temporary inferior vena cava filter and catheter contact thrombolysis is a safe and effective treatment for acute pulmonary embolism secondary to pelvic vein thrombosis.