【摘要】 目的探讨急性肺栓塞早期溶栓疗效及溶栓前后超声变化。方法对超声显示有右心收缩期负荷过重表现的患者行早期经静脉溶栓,并在24小时后观察超声变化。结果肺栓塞26例,适宜溶栓者24例,给予早期溶栓,溶栓有效20例,12小时内溶栓有效率与12小时后溶栓有效率相比有显著差异(P<0.01)。溶栓成功组肺动脉收缩压(PASP)由59.1±16.3mmHg降至41.5±14.1mmHg(P<0.01),右室舒张末内径(RVDD)由34±5.3mm降至29.1±5.0mm(P<0.01),右室舒张末内径/左室舒张末内径(RVDD/LVDD)>0.6的例数由16例降至4例,三尖瓣返流速度(TR)由3.9±0.5m/s降至2.3±0.54m/(sP<0.01),收缩期室间隔反常运动(PSM)由18例降至4例。溶栓未成功组以上参数无显著变化(P>0.3)。结论超声心动图可作为肺栓塞早期诊断及溶栓后疗效评价的方法。更多还原

【Abstract】 Objective To evaluate the effect of thrombolytic therapy in early stage of acute pulmonary embolism by the echocardiography. Methods Patients with right ventricular systolic pressure overloads in echocardiography were treated with thrombolytic agents in early stage ,and observed the changes in echocardiography arter24 hours. Results Of 26 patients of acute pulmonary embolism,24 cases who were suitable for thrombolytic therapy were treated in early stage,20patients had effective,There was significant difference in the ratio of effect betten in 12 hours and over 12 hour ,in the group, the pulmonary systolic pressure (PASP) decreased from (59.1±16.3 mmHg) to(41.5±14.1 mmHg)P<0.01,the diameter of right ventricular diastolic (RVDD) decreased from (34±5.3 mm) to (29.1±5.3 mm) P<0.01,the cases with the ratio of RVDD and LVDD (RVDD/LVDD )>0.6 decreased from 16 to 4,the speed of tricuspid regurgitation reduced from (3.9±0.5 m/s) to (34±0.54 m/s) P<0.01,the cases with the systolic paradoxical septum motion decreased from 16 to 4;In ineffective group,the parameters had no significant changes. Conclusion Echocardiography is a good method for diagnosis of pulmonary embolism and accessment of the effects of thrombolytic therapy.更多还原