【摘要】 目的比较不同溶栓方法治疗急性肺栓塞的疗效。方法 2010年1月至2011年12月收治20例急性期(2周内)肺血栓栓塞症患者,采用导管接触溶栓(10例)和静脉溶栓(10例)治疗,综合判断两种治疗方法的有效性、合理性和安全性。结果 20例患者均因劳力性呼吸困难就诊,其中15例有明确的下肢静脉疾患(深静脉血栓症、深静脉炎或下肢静脉曲张),3例有晕厥史。经抗凝、溶栓治疗后,患者的呼吸频率、心率均较溶栓前显著改善。影像检查显示血栓部分或全部溶解消失。治疗总有效率为100%。与静脉溶栓组相比,导管接触溶栓组患者在治疗初期临床表现改善明显,且尿激酶用量少,发生溶栓并发症的机会大大减少。结论与静脉溶栓相比,导管接触溶栓治疗急性肺栓塞患者的临床症状改善较快,短期复查各项检查结果优于后者。更多还原

【Abstract】 Objective To compare the clinical effectiveness of different thrombolytic therapies in treating acute pulmonary thromboembolism.Methods During the period from January 2010 to December 2011,a total of 20 patients with acute pulmonary thromboembolism were admitted to authors’ hospital within two weeks after the onset of the disease.The patients were randomly and equally divided into two groups: catheter-directed thrombolysis group(n = 10) and venous thrombolysis group(n= 10).The clinical effectiveness, rationality and safety of the two therapies were separately and comprehensively evaluated.The results were compared between the two groups.Results All the twenty patients went to see a doctor because of exertion dyspnea.Fifteen patients had definite lower limb venous diseases,including deep vein thrombosis,deep vein phlebitis and lower limb varicosity.Three patients had a history of syncope.After anticoagulant and thrombolytic therapy,the respiration rate and heart rate were significantly improved in all patients.Imaging examinations showed that the thrombi were partially or completely dissolved.The total effectiveness rate was 100%.Compared to patients of venous thrombolysis group,patients of catheter-directed thrombolysis group showed more apparent improvement in clinical manifestations at early stage of treatment.Besides,in catheterdirected thrombolysis group the urokinase amount used in procedure was less and the occurrence of complications was lower.Conclusion Compare to venous thrombolysis therapy,catheter-directed thrombolysis therapy can quickly improve the patient’s clinical symptoms,and both the imaging findings and laboratory tests can also be markedly improved in short time.更多还原