急性高危肺栓塞介入取栓、溶栓中应用r-tPA与尿激酶溶栓时间及疗效比较

发布时间：2018-04-05 06:17

本文选题：肺栓塞　切入点：血栓溶解疗法　出处：《北京大学学报(医学版)》2014年03期

【摘要】：目的:探讨急性高危型肺栓塞患者经介入取栓后,应用r-tPA和尿激酶行介入溶栓治疗,对疗效和溶栓时间的影响。方法:回顾性分析19例急性高危型肺栓塞患者的临床资料,根据其应用r-tPA或尿激酶行介入溶栓分为两组,比较两组间溶栓前后心率、血压、肺动脉压、动脉血氧分压和血红蛋白的变化,以及两组的溶栓时间。结果:各组患者术前和术后心率、血压、动脉血氧分压均有明显改善(P0.05);应用r-tPA组患者术后肺动脉压较术前有所降低,但差异无统计学意义(P0.05),应用尿激酶组患者术后肺动脉压较术前显著降低(P0.05)。两组患者术后血红蛋白均未出现明显降低(P0.05);应用r-tPA组患者溶栓时间明显短于应用尿激酶组患者(P0.05)。结论:应用r-tPA与尿激酶行急性高危型肺栓塞的介入溶栓治疗均有效,但应用r-tPA能够显著缩短溶栓时间,且不增加出血风险。
[Abstract]:Objective: to investigate the effect of interventional thrombolytic therapy with r-tPA and urokinase after interventional thrombolysis in patients with acute high risk pulmonary embolism.Methods: the clinical data of 19 patients with acute high risk pulmonary embolism were retrospectively analyzed. According to the interventional thrombolysis with r-tPA or urokinase, the heart rate, blood pressure and pulmonary artery pressure were compared before and after thrombolysis.Changes in arterial partial pressure of oxygen and hemoglobin, and thrombolytic time in both groups.Results: the heart rate, blood pressure and arterial oxygen partial pressure were significantly improved in each group before and after operation, and the pulmonary artery pressure in r-tPA group was lower than that before operation.But there was no significant difference (P 0.05). The pulmonary artery pressure in urokinase group was significantly lower than that before operation.The time of thrombolytic therapy in r-tPA group was significantly shorter than that in urokinase group.Conclusion: interventional thrombolytic therapy with r-tPA and urokinase for acute high risk pulmonary embolism is effective, but r-tPA can significantly shorten thrombolysis time and does not increase the risk of bleeding.
【作者单位】：北京大学第三医院介入血管外科;
【分类号】：R563.5

【参考文献】