[1]罗 祥,宋 韵△,郭春丽,等.局部灌注瑞替普酶溶栓在高危肺动脉栓塞患者行经肺动脉内 导管碎栓介入治疗 中的效果与安全性研究[J].陕西医学杂志,2019,(2):266-269.
 LUO Xiang,SONG Yun,GUO Chunli,et al.Local perfusion rui at enzyme thrombolysis therapy in highrisk patients with pulmonary embolism 〖JP〗 〖JP3〗menstruation in the pulmonary artery catheter broken bolt effect and safety of interventional treatment〖JP〗〖WT4”BZ〗[J].,2019,(2):266-269.
点击复制

局部灌注瑞替普酶溶栓在高危肺动脉栓塞患者行经肺动脉内 导管碎栓介入治疗 中的效果与安全性研究
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年2期
页码:
266-269
栏目:
药物与临床
出版日期:
2020-02-05

文章信息/Info

Title:
Local perfusion rui at enzyme thrombolysis therapy in highrisk patients with pulmonary embolism 〖JP〗 〖JP3〗menstruation in the pulmonary artery catheter broken bolt effect and safety of interventional treatment〖JP〗〖WT4”BZ〗
文章编号:
DOI: 10.3969/j.issn.10007377.2019.02.035
作者:
罗 祥1宋 韵1△郭春丽1和建武1秦 皓2
1.陕西省铜川市人民医院(铜川 727031);2.西安交通大学第一附属医院(西安 710061)
Author(s):
LUO XiangSONG YunGUO Chunliet al.
Tongchuan People’s Hospital in Shaanxi Provincs(Tongchuan 727000)
关键词:
瑞替普酶肺动脉栓塞经肺动脉内导管碎栓介入治疗疗效溶栓并发症
Keywords:
Key words At enzymePulmonary embolism The pulmonary artery catheter broken bolt interventional therapy The curative effectThrombolysis Complications
分类号:
R563.5
文献标志码:
A
摘要:
摘 要 目的:探讨高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中,局部灌注瑞替普酶(rPA)溶栓治疗的效果与安全性。方法:选取符合研究标准的54例高危肺动脉栓塞住院患者,随机分为对照组24例和治疗组30例,患者均行一般治疗、低分子肝素钠抗凝治疗、介入碎栓治疗和经介入治疗对照组给予局部灌注阿替普酶溶栓治疗,治疗组则给予局部灌注瑞替普酶溶栓治疗。结果:①两组溶栓治疗3 d后血流变(HR)和风湿因子(RF)明显减慢,动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2) 和血氧饱和度(SaO2)等血气分析指标也较前明显改善,两组各自溶栓前、后指标比较差异具有统计学意义(P<0.05),其中治疗组(瑞替普酶)溶栓后差异较对照组(阿替普酶)更为显著。②溶栓3 d后,治疗组30例中,治愈30.00%,显效50.00%,无效13.33%,无恶化和死亡病例,总治疗效果有效率为86.67%;对照组24例中,治愈25.00%,显效50.00%,无效25.00%,其中恶化1例(4.17%),无死亡病例,总治疗效果有效率75.00%。治疗组治愈率30.00%显著高于对照组25.00%(P<0.05);治疗组总治疗效果有效率86.67%显著高于对照组75.00%(P<0.05)。③溶栓治疗后,治疗组出血率13.33%,对照组出血率12.50%,两组溶栓治疗后出血率比较差异无统计学意义(P>0.05)。结论:局部灌注瑞替普酶溶栓治疗在高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中疗效好,安全性高。
Abstract:
Abstract Objective:To explore the high risk patients with pulmonary embolism is passing a pulmonary artery catheter broken bolt in the interventional treatment, evaluation of regional perfusion rui at enzyme (rPA) thrombolytic effect and safety of treatment.Methods:Selected 54 high risk as the research object, up to the study standard hospitalized patients with pulmonary embolism and 24 cases were randomly divided into control group and treatment group 30 cases, patients with general treatment and low molecular heparin sodium anticoagulation therapy, interventional broken bolt and the intervention group at o give local perfusion thrombolysis enzyme treatment; Experimental group was given local perfusion at enzyme thrombolysis treatment. Results:①Two groups of subjects three days after thrombolysis treatment of HR and RF slowed significantly, PaO2, SaO2 and PaCO2 also improved significantly earlier blood gas analysis index, index of two groups before and after each cell (bolt differences statistically significant (P<0.05), the experimental group (at enzyme) difference of which was more significant than the control group after thrombolysis. ②Three days after thrombolysis, the experimental group 30 cases, cure 30.00%, had marked effect 50.00%, invalid 13.33% , it had no deterioration and death cases, the treatment effective rate was 86.67%; Control group 24 cases, cure 25.00%, had marked effect 50.00%, invalid 25.00% , the deterioration in 1 case (4.17%), no deaths, 75.00% of the total therapeutic effect efficiently. Experimental group cure rate 30.00% is significantly higher than the control group 25.00%(P<0.05); The experimental group 86.67% of the total therapeutic effect efficiently is significantly higher than the control group 86.67%(P<0.05). ③After thrombolysis treatment, the experimental group hemorrhage rate was 13.33%, the control hemorrhage rate was 12.50%, 〖LM〗including bleeding rate difference between the two groups after thrombolysis treatment has no statistical significance(P>0.05), the hemorrhage patients were symptomatic treatment, illness, has not been observed two groups of patients in the process of severe bleeding.Conclusion:Local perfusion rui at enzyme thrombolysis therapy in highrisk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment and adopted treatment is worth clinical promotion.

参考文献/References:

\[1\] 黄俊伟,张 晨,张尉华.肺血栓栓塞症患者相关危险因素\[J\].中国老年学杂志,2015,13(5):87106.
\[2\] 金 焱,崔四龙,刘东亮,等.瑞替普酶与阿替普酶在急性肺栓塞溶栓治疗中的比较研究\[J\].中国煤炭工业医学杂志,2012,15(11):135141.
\[3\] 宋锦文,王志宏,王新林,等.高危肺动脉栓塞介入治疗的疗效评价\[J\].西北国防医学杂志,2015,36(1):2532.
\[4\] 中华医学会呼吸病学分会.肺血栓栓塞症的诊断与治疗指南\[J\].中华结核和呼吸杂志,2001,24(5):259264.
\[5\] 〖JP3〗Torbicki A,Perrier A,Konstan tinipes S,et al.Guidelines on the diagnosis and management of acute pulmonary embolism:the task force for the diagnosis and management of acute pulmonary embolism of the European Society of Gardiology(ESC)\[J\].Eur Heart J,2008,29(18):22762315.〖JP〗
\[6\] 宋锦文,王志宏,王新林,等.导管碎栓联合局部灌注瑞替普酶溶栓治疗高危肺动脉栓塞\[J\].介入放射学杂志,2014,23(10):7176.
\[7\] 王 晖,余朝文,官泽宇.血管腔内成形术治疗髂股静脉血栓形成后综合征的临床疗效\[J\].中国普外基础与临床杂志,2013,25(17):125131.
\[8\] 中华医学会心血管病学分会肺血管病学组,中国医师协会心血管内科医师分会.急性肺血栓栓塞症诊断治疗中国专家共识\[J\].中华内科杂志,2010,49(1):7481.
\[9\] 杨国珍.急性肺栓塞的诊断及治疗进展\[J\].世界最新医学信息文摘,2015,15(21):2735.
\[10\] 陈 亮,顾建平,楼文胜,等.介入联合静脉溶栓在急性肺栓塞治疗中的应用\[J\].中国医疗设备,2014,29(11):278283.〖ZK)〗
\[11\] 葛均波,徐永康.内科学\[M\].8版.北京:人民卫生出版社,2013:119.
\[12\] 秦黎明,王阿莉,左 红,等.介入治疗急性肺动脉栓塞疗效\[J\].临床荟萃,2014,29(9):543547.
\[13\] 张 喆,冯 海,于宏志,等.肺动脉置管溶栓治疗急性肺栓塞\[J\].中国血管外科杂志,2014,6(4):253256.
\[14\] 许 欣,杜 军.急性肺栓塞的诊治进展\[J\].临床荟萃,2013,28(6):699702.
\[15\] 靳培敏.瑞替普酶、尿激酶溶栓治疗急性肺栓塞临床对比研究\[J\].中国医学工程,2015,23(1):213117.
\[16\] 张明亮,王爱萍,尹鲁骅,等.急性大面积肺栓塞应用不同剂量瑞替普酶溶栓治疗的血流动力学效果及安全性\[J\].心脏杂志,2014,26(5):103113.

相似文献/References:

[1]薛大鹏,唐鸿渠,刘 敏.多层螺旋CT在肺动脉栓塞诊断中的价值研究[J].陕西医学杂志,2019,(7):879.
 XUE Dapeng,TANG Hongqu,LIU Min..The value of multi-slice spiral CT in the diagnosis of pulmonary embolism[J].,2019,(2):879.
[2]郭 华,白 洁,梁乐乐,等.胸痛血管三联合成像Meta分析*[J].陕西医学杂志,2019,(10):1402.

更新日期/Last Update: 2019-03-13