留置导管溶栓治疗急性肺栓塞中期疗效分析

摘要

Objective Pulmonary embolism is a common cardiovascular emergency with the characteristics of high incidence,high mortality.This study compared pulmonary artery catheter thrombolysis with peripheral intravenous thrombolysis for acute pulmonary embolism in the mid-term clinical efficacy.Methods From June 2011 to September 2015,68 patients were given pulmonary artery interventional therapy,54 cases received peripheral intravenous thrombolysis;discharged patients were followed up for 3-12 months to evaluate the curative rate,effective rate,recurrence rate and the incidence of complications.Results Follow up rate was 79.5％.The cure rate of the treatment group was higher than that of the control group (47.3 ％ vs 23.8 ％,P ＜ 0.05);The significant effective rate of the treatment group was higher than that of the control group (81.8％ vs 52.4％,P ＜ 0.05);The incidence of Chronic pulmonary hypertension (1.8％) was lower than that of the control group (16.7％);There was no significant difference in improvement rate,recurrence rate and mortality.Conclusion The medium-term efficacy of pulmonary artery catheter directed thrombolysis is superior to that of peripheral intravenous thrombolysis;it can effectively reduce the incidence of chronic thromboembolic pulmonary hypertension.%目的 总结肺动脉留置导管溶栓治疗急性肺栓塞患者的经验.方法 回顾性分析2011年6月至2015年9月赤峰市医院诊治的急性肺栓塞患者的临床资料,根据患者知情自愿选择方法对68例患者给予肺动脉留置导管溶栓治疗,54例经周围静脉溶栓治疗;对2组患者进行中期(3～12个月)随访,通过患者临床症状体征、肺动脉CTA及并发症的发生评价治疗效果,从治愈率、显效率、好转率、复发率及并发症发生率等方面评价中期临床疗效.结果 总随访率79.5％,导管组随访治愈率显著高于外周溶栓组(47.3％比23.8％,P＜0.05),显效率明显高于外周溶栓组(81.8％比52.4％,P＜0.05);导管组慢性肺动脉高压发生率(1.8％)显著低于外周溶栓组(16.7％),差异有统计学意义;2组患者好转率、复发率及病死率对比无统计学差异.结论 肺动脉留置导管溶栓中期疗效优于经外周静脉溶栓;可以有效降低慢性血栓栓塞性肺动脉高压的发生率.