Clinical Curative Effect on Acute Pulmonary Embolism via Percutaneous Catheter Intervention_West China Medical Journal

Authors：

WANG Wei ¹ , LUO Fuquan ¹ , ZHANG Nuofu ² , WANG Min ¹

1. Department of Cardiology, The first Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong 510120, P. R. China; 2. Guangzhou Institute of Respiratory Disease, Guangdong 510120, P. R. China;

Corresponding author：

Keywords：

肺栓塞; 介入治疗; 肺动脉; 溶栓术

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【摘要】目的 观察经皮导管介入治疗急性肺栓塞的疗效。方法选择2003年1月-2009年6月收治的急性肺栓塞患者15例，采用经皮导管吸栓术、碎栓术及溶栓术治疗。溶栓术用局部灌注加即刻静脉注射尿激酶，总量100万U。溶栓后给予低分子肝素7~10 d，口服华法林3~6个月。观察临床症状、体征改善情况、并发症、平均肺动脉压（mPAP）与动脉血氧分压（PO2）的变化，以及肺动脉开通情况。结果 12例肺动脉完全开通，3例部分开通，显效率89%，有效率100%。mPAP从（41.07±6.97） mm Hg降到（21.00±5.66） mm Hg，PO2从（46.26±9.30） mm Hg升到（79.49±8.04） mm Hg，治疗前后差异有统计学意义（P lt;0.05）。即刻临床症状明显改善，mPAP迅速降低11例。随访3~6个月，疗效持续，未见复发。结论介入治疗急性肺栓塞疗效显著，安全可行，对抢救危重患者、改善临床症状、维持血流动力学稳定有重要作用。
【Abstract】 Objective To observe the clinical curative effect on acute pulmonary embolism(PE)via percutaneous catheter intervention. Methods Fifteen acute PE patients admitted from January 2003 to June 2009 were treated with percutaneous catheter drawing of thrombus, thrombectomy, and thrombolysis. Local infusion and immediate intra-venous injection of urokinase with 100 000 000 U in total were used for thrombolysis. Afterwards, the low molecular weight heparin was given for seven to ten days, and an oral intake of warfarin lasts for three to six months. Observe the clinical symptoms, improvement of physical signs, occurrence of complications, change of mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen (PO2), as well as the patency condition of pulmonary artery. Results Twelve of fifteer patients gained complete patency of pulmonary artery, and the other three patients gained partial patency, with an obvious effectiveness rate of 89% and an effectiveness rate of 100%. mPAP decreased from (41. 07±6. 97) mm Hg to (21. 00±5. 66) mm Hg, and PO2 elevated from (46. 26±9. 30) mm Hg to (79. 49±8. 04) mm Hg, showing a significant difference (P lt;0. 05) before and after the therapy. The immediate clinical symptoms exhibited a significant improvement. The pulmonary artery pressure of 11 patients dropped rapidly. During three to six months’ follow up, the therapeutic effects persisted and no recurrence was found. Conclusion The interventional treatment of acute PE demonstrates remarkable effectiveness, safety and feasibility, which plays an important role in the rescue of critical patients, improvement of clinical symptoms, and maintenance of hemodynamic stability.

Citation： WANG Wei,LUO Fuquan,ZHANG Nuofu,WANG Min. Clinical Curative Effect on Acute Pulmonary Embolism via Percutaneous Catheter Intervention. West China Medical Journal, 2010, 25(8): 1403-1405. doi: Copy

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1. Arcasoy SM, Kreit JW. Thrombolytie therapy of pulmonary embolism: a comprehensive review of current evidence[J]. Chest, 1999, 115(6): 1695-1707. .
2. 房芳, 温绍君, 张维君, 等. 肺栓塞诊断进展[J]. 中国介人心脏病学杂志, 2001, 9(3): 159-161. .
3. Uflacker R. Interventional therapy for pulmonary embolism[J]. J Vasc Interv Radiol, 2001, 12(2): 147-164. .
4. 程显声. 肺栓塞防治研究的现状与展望[J]. 中华心血管病杂志, 2001, 29(5): 257-258. .
5. 张维君, 温绍君, 马涵英, 等. 急性肺栓塞的介入治疗[J]. 中华心血管病杂志, 2001, 29(5): 268-269. .
6. Kasper W, Konstantinides S, Geibel A, et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of multicenter registry[J]. J Am Coll Cardiol, 1997, 30(5): 1165-1171. .
7. 吴文辉, 戴汝华. 肺动脉栓塞诊断的现代策略[J]. 当代医学, 2001, 7(3): 31-33. .
8. 程显声. 急性肺栓塞的诊治进展[J]. 现代实用医学杂志, 2003, 15(10): 599-601. .

West China Medical Journal

Clinical Curative Effect on Acute Pulmonary Embolism via Percutaneous Catheter Intervention

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