CAJ | 학술논문

目的：探讨急性大面积肺动脉栓塞通过介入治疗的方法，评估其临床疗效。方法对16例急性肺动脉栓塞，明确血栓均来源于下肢深静脉血栓的患者，先行放置下腔静脉滤器，再术中行肺动脉造影，通过旋转猪尾导管、导丝碎栓、负压抽吸导管和局部溶栓来开通肺动脉。观察临床症状、休克指数、脑利纳肽( BNP)，血氧饱和度SaO 2和术后胸部增强CT肺动脉开通情况。结果术中或术后症状即刻缓解15例，完全开通5例；部分开通10例，但术后规范化抗凝溶栓治疗，复查胸部增强CT肺动脉完全开通，休克指数、BNP较术前明显降低( P<0．05) SaO 2与术前相比明显升高( P<0．05)，死亡1例(非手术因素)。结论在不具备开胸取栓危急情况下，介入治疗能及时开通肺动脉，恢复肺动脉血流动力学，纠正低氧血症，可取得“立竿见影”的治疗效果，是治疗挽救肺动脉栓塞患者一种有效的方法，值得推广。
목적：탐토급성대면적폐동맥전새통과개입치료적방법，평고기림상료효。방법대16례급성폐동맥전새，명학혈전균래원우하지심정맥혈전적환자，선행방치하강정맥려기，재술중행폐동맥조영，통과선전저미도관、도사쇄전、부압추흡도관화국부용전래개통폐동맥。관찰림상증상、휴극지수、뇌리납태( BNP)，혈양포화도SaO 2화술후흉부증강CT폐동맥개통정황。결과술중혹술후증상즉각완해15례，완전개통5례；부분개통10례，단술후규범화항응용전치료，복사흉부증강CT폐동맥완전개통，휴극지수、BNP교술전명현강저( P<0．05) SaO 2여술전상비명현승고( P<0．05)，사망1례(비수술인소)。결론재불구비개흉취전위급정황하，개입치료능급시개통폐동맥，회복폐동맥혈류동역학，규정저양혈증，가취득“립간견영”적치료효과，시치료만구폐동맥전새환자일충유효적방법，치득추엄。
Objective To evaluate the effectiveness of pulmonary embolectomy by cathether for the treatment of acute mas-sive pulmonary embolism. Methods 16 case were diagnosed pulmonary embolism( patients with deep vein thrombosis) ,first re-lease of the inferior vena cava filter,treated by thrombus fragmentation and suction by cathethers,and local fibrinolysis. Observation of clinical symptoms,shock index,brain peptide (BNP),blood oxygen saturation SaO2 and postoperative breast enhancement CT pulmonary artery open. Results the intraoperative and postoperative symptom alleviate immediate 15 cases,completely open in 5 cases;Part opened 10 cases,but the postoperative standardization of anticoagulant thrombolytic therapy,review the breast enhance-ment CT pulmonary artery completely opening,shock index,the BNP compared with preoperative SaO 2 decreased obviously ( P<0. 05) compared with the preoperative increased significantly (P<0. 05),1 cases died (non-surgical factors). Conclusion In the absence of thoracotomy embolectomy emergency situation,the timely opening of interventional pulmonary artery,pulmonary hemody-namics restored to correct hypoxemia,it is the treatment of pulmonary embolism in patients with an effective remedy approach,and worthy of promotion.