CAJ | 학술논문

目的提高对骑跨型肺栓塞的认识,为探讨其发病过程及制定合理的治疗方案提供依据.方法对我院2004年1月至2012年1月经CT肺动脉造影(CTPA)检查确诊的骑跨型肺栓塞患者进行回顾性分析结果经CTPA确诊肺栓塞338例,其中骑跨型肺栓塞15例,占4.4％男7例,女8例,平均年龄(57±13)岁肺动脉分叉处完全阻塞1例,部分阻塞14例伴休克l例,伴低血压3例,血流动力学稳定11例,伴卯圆孔骑跨栓l例.溶栓治疗5例,单纯抗凝治疗9例,行血栓清除术1例.治愈5例,好转10例,末见死亡病例.治疗过程中轻微出血2例,无大出血病例结论本组骑跨型肺栓塞发病率与国外报道基本一致,但这一发病率可能被低估,对于血流动力学稳定, 且不伴有卵圆孔骑跨栓的骑跨型肺栓塞患者并不需要积极地溶栓或手术治疗.
목적 제고대기과형폐전새적인식,위탐토기발병과정급제정합리적치료방안제공의거.방법 대아원2004년1월지2012년1월경CT폐동맥조영(CTPA)검사학진적기과형폐전새환자진행회고성분석 결과 경CTPA학진폐전새338례,기중기과형폐전새15례,점4.4％남7례,녀8례,평균년령(57±13)세 폐동맥분차처완전조새1례,부분조새14례 반휴극l례,반저혈압3례,혈류동역학은정11례,반묘원공기과전l례.용전치료5례,단순항응치료9례,행혈전청제술1례.치유5례,호전10례,말견사망병례.치료과정중경미출혈2례,무대출혈병례결론 본조기과형폐전새발병솔여국외보도기본일치,단저일발병솔가능피저고,대우혈류동역학은정, 차불반유란원공기과전적기과형폐전새환자병불수요적겁지용전혹수술치료.
Objective To improve recognition of saddle pulmonary embolism (SPE).Methods A retrospectively review was performed for patients diagnosed with SPE determined by CTPA from Jan 2004 to Jan 2012.Results Fifteen SPE patients(4.44％) were found in 338 documented PE patients confirmed by CTPA.There were 7 males and 8 females,with an average age of (57 ± 13) years.The bifurcation of the main pulmonary artery was completely blocked in one case,while partial obstruction was found in the others.Hemodynamic stability was observed in 11 cases,shock in 1 case,and hypotension in 3 cases.Thromboembolectomy was performed in 1 case accompanied by patent foramen ovale straddling thrombus,and thrombolytic therapy was administered in 5 cases while anticoagulant therapy alone in 9 cases.All the cases survived.Minor bleeding was observed in 2 patients and no major bleeding occurred.Conclusion The prevalence of SPE in this series was similar to that reported in the literature.But the incidence might beunderestimated.Mortality rate was low.No more aggressive therapeutic interventions (thrombolytics or catheter thrombectomy) were needed in those patients with hemodynamic stalbility and without patent foramen ovale straddling thrombus.