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Received:June 10, 2020 Published Online:December 20, 2020
Received:June 10, 2020 Published Online:December 20, 2020
中文摘要: 目的 对比经足背静脉静脉溶栓与大腔导管抽栓联合置管小剂量尿激酶溶栓在急性中高危肺栓塞中的临床应用价值。方法 选取2015年1月至2019年12月临床表现、肺动脉CT造影及数字减影血管造影明确诊断为急性中高危肺栓塞60例,其中对照组30例在抗凝的基础上经足背静脉留置针溶栓,研究组30例在抗凝的基础上进行大腔导管抽栓联合置管小剂量尿激酶溶栓,观察两组患者肺动脉血栓清除时间、血氧饱和度恢复(>95%)时间、临床症状缓解时间、出血发生率及住院时间。结果 研究组肺动脉血栓清除时间、血氧饱和度恢复时间、临床症状缓解时间及住院时间等指标均少于对照组,差异有统计学意义(P<0.05);两组患者出血发生率比较,研究组(10.00%)略大于对照组(6.67%),但差异没有统计学意义(P>0.05)。结论 在抗凝的基础上进行大腔导管抽栓联合置管小剂量尿激酶溶栓治疗急性中高危肺栓塞可以在短时间内让患者度过危险期,无严重并发症发生,是一种微创、安全、高效的方法。
Abstract:Objective To compare the clinical application value of intravenous thrombolysis via dorsalis pedis vein and large lumen catheter combined with small dose urokinase in the treatment of middle and high risk pulmonary embolism. Methods A total of 60 patients who were diagnosed as acute moderate and high-risk pulmonary embolism according to their clinical manifestations, pulmonary CTA and DSA angiography from January 2015 to December 2019 were selected and divided into control group and study group (n=30, each).The patients in the control group were treated with anticoagulation and thrombolysis through dorsal vein of foot.On the basis of anticoagulation, the study group was treated with large lumen catheter and small dose of urokinase.The recovery time of pulmonary artery bleeding, the time of pulmonary artery blood saturation and the time of oxygen saturation (>95%) recovery in the two groups. Results The time of pulmonary artery thrombus clearance, oxygen saturation recovery time, clinical symptoms remission time and hospitalization time in the study group were less than those in the control group (P<0.05).The incidence of bleeding in the study group was slightly higher than that in the control group without significant difference (10.00% vs 6.67%,χ2=0.22, P=0.64). Conclusion On the basis of anticoagulation, large lumen catheter thrombectomy combined with low-dose urokinase thrombolysis in the treatment of acute middle and high-risk pulmonary embolism can let patients through the dangerous period in a short time without serious complications.It is a minimally invasive, safe and efficient method.
keywords: Pulmonary embolism Urokinase Catheter thrombolysis
文章编号: 中图分类号:R543.2 文献标志码:B
基金项目:南京市卫健委科技发展基金(YKK18242)
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