【摘要】 目的 评估瑞替普酶联合导管碎栓技术治疗肺栓塞的疗效及安全性。方法 回顾性分析行经导管脉冲灌注瑞替普酶联合导管碎栓技术治疗的急性肺栓塞患者12例,观察患者手术前后症状缓解情况及血气分析、凝血功能、并发症等发生情况,随访研究患者术后肺动脉CT血管成像(CTA)情况。结果 12例患者中无围术期死亡者。随访时间2～11个月。术后所有患者症状改善,无出血、心律失常等相关并发症。纤维蛋白原(FIB)较术前无明显下降,纤维蛋白降解产物(FDB)术后明显升高。随访发现肺动脉栓塞明显减轻,并未见肺栓塞复发表现。结论 瑞替普酶联合导管碎栓技术可有效减少肺动脉血栓负荷,改善患者呼吸功能,且不增加患者出血风险,该技术治疗肺栓塞安全、有效。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of reteplase combined with percutaneous catheter thrombectomy in the treatment of pulmonary embolism.Methods Twelve patients with acute pulmonary embolism who were treated by reteplase combined with percutaneous catheter thrombectomy were analyzed retrospectively.The symptom was observed before and after the operation,as well as the status of blood gas analysis,coagulation function and complications.The postoperative pulmonary artery condition was followed up by computed tomography angiography(CTA).Results A total of 12 patients were enrolled in this study,and no patients died during the perioperative period.The follow-up time was 2-11 months.All patients’ symptoms were relieved after the operation,without bleeding,arrhythmia and other complications.Fibrinogen(FIB) did not decrease significantly before the operation,while the fibrin degradation product(FDB) increased significantly after the operation.Pulmonary embolism was significantly reduced and no recurrence was found during the follow-up.Conclusion Reteplase combined with percutaneous catheter thrombectomy can effectively reduce the burden of pulmonary artery thrombus and improve respiratory function,and do not increase the risk of bleeding.This technology is safe and effective in the treatment of pulmonary embolism.更多还原