CAJ | 학술논문

目的：探讨急性高危型肺栓塞患者经介入取栓后，应用r-tPA和尿激酶行介入溶栓治疗，对疗效和溶栓时间的影响。方法：回顾性分析19例急性高危型肺栓塞患者的临床资料，根据其应用r-tPA或尿激酶行介入溶栓分为两组，比较两组间溶栓前后心率、血压、肺动脉压、动脉血氧分压和血红蛋白的变化，以及两组的溶栓时间。结果：各组患者术前和术后心率、血压、动脉血氧分压均有明显改善（P＜0．05）；应用r-tPA组患者术后肺动脉压较术前有所降低，但差异无统计学意义（P＞0．05），应用尿激酶组患者术后肺动脉压较术前显著降低（P＜0．05）。两组患者术后血红蛋白均未出现明显降低（ P＞0．05）；应用r-tPA组患者溶栓时间明显短于应用尿激酶组患者（ P＜0．05）。结论：应用r-tPA与尿激酶行急性高危型肺栓塞的介入溶栓治疗均有效，但应用r-tPA能够显著缩短溶栓时间，且不增加出血风险。
목적：탐토급성고위형폐전새환자경개입취전후，응용r-tPA화뇨격매행개입용전치료，대료효화용전시간적영향。방법：회고성분석19례급성고위형폐전새환자적림상자료，근거기응용r-tPA혹뇨격매행개입용전분위량조，비교량조간용전전후심솔、혈압、폐동맥압、동맥혈양분압화혈홍단백적변화，이급량조적용전시간。결과：각조환자술전화술후심솔、혈압、동맥혈양분압균유명현개선（P＜0．05）；응용r-tPA조환자술후폐동맥압교술전유소강저，단차이무통계학의의（P＞0．05），응용뇨격매조환자술후폐동맥압교술전현저강저（P＜0．05）。량조환자술후혈홍단백균미출현명현강저（ P＞0．05）；응용r-tPA조환자용전시간명현단우응용뇨격매조환자（ P＜0．05）。결론：응용r-tPA여뇨격매행급성고위형폐전새적개입용전치료균유효，단응용r-tPA능구현저축단용전시간，차불증가출혈풍험。
Objective:To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy .Methods:After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients , we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate , blood pressure , pulmonary arterial pressure , arterial partial pressure of oxygen and hemachrome before and after thrombolysis , as well as the thrombolysis effect time the two groups took.Results: The heart rate, blood pressure, pulmonary arterial pressure , arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation ( P<0 .05 );the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation ( P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation ( P<0.05 ); the hemachrome of both patient groups did not significantly drop after operation ( P>0 .05 );the thrombolysis effect time by adop-ting r-tPA was remarkably shorter than that caused in thrombolysis by adopting urokinase ( P<0 .05 ) . Conclusion: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism .However , r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.