急性肺动脉血栓栓塞症局部溶栓与静脉溶栓的比较研究

Comparison of Local Pulmonary Arterial Thrombolysis and Peripheral Intravenous Thrombolysis in Pulmonary Embolism Therapy

目的 :研究经皮导管肺动脉局部溶栓和外周静脉给药溶栓两种溶栓方式在急性肺栓塞治疗中的作用。方法 :急性肺栓塞 3 6例患者分别予经皮导管肺动脉局部溶栓 (局部溶栓组 )和经外周静脉给药溶栓 (静脉溶栓组 ) ,溶栓前和溶栓后 48小时测动脉血气和肺血管造影。结果 :两组治疗后动脉氧分压 (PaO2 )均增加 ,肺泡动脉氧分压差 (AaDO2 )均降低 ,与治疗前相比差异非常显著 (P <0 0 1)。局部溶栓组PaO2 上升幅度高于静脉溶栓组 ,但差异无显著性。局部溶栓组肺动脉造影血管阻塞改善率较静脉溶栓组高 ( 82 4%和 66 7% ) ,但差异无显著性。结论 :溶栓治疗有效 ,局部溶栓与静脉溶栓效果相似。

Objective: To study the clinical effect of local pulmonary arterial thrombolysis by catheter and peripheral intravenous thrombolysis in pulmonary embolism therapy. Methods: Thirty-six patients were divided into two treatment groups.Arterial blood gas analysis and angiography were done before and 48 hours after thrombolysis. Results: Partial pressure of oxygen in artery(PaO 2)was increased and alveolar-arterial oxygen difference(AaDO 2)decreased after thrombolysis in both groups(p<0.01). PaO 2 was more increased in the local thrombolysis group than in the peripheral intravenous thrombolysis group,but not much significant(p>0.05). The response rate of angiography in the local thrombolysis group was higher than in the peripheral intravenous thrombolysis group (82.4% vs 66.7%,p>0.05). Conclusion: Thrombolysis is effective.The two routes of administration offer similar effect.