急性肺栓塞的手术治疗

发布时间：2018-01-27 10:10

本文关键词： 急性肺栓塞肺动脉血栓清除术手术治疗　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：急性肺栓塞是一种常见临床急诊,具有高发病率和高病死率。肺动脉血栓清除术一直以来用于严重急性肺栓塞的紧急抢救治疗,其地位一直伴有争议,本文通过查阅已发表的关于肺动脉血栓清除术的文献,探讨肺动脉血栓清除术的现状。结果显示肺动脉血栓清除术的死亡率呈下降趋势,近年来累计死亡率分别为15.3%(2010~2011)、12.6%(2012~2013)和6.6%(2014~2015),这种趋势证实肺动脉血栓清除术具有越来越好的临床疗效。与溶栓治疗相比,肺动脉血栓清除术在术后早期死亡率、出血及肺塞复发方面,具有低于溶栓治疗的趋势。术前血流动力学状态和术前心脏骤停等因素可显著影响肺动脉血栓清除术的预后。随着对肺栓塞的不断认识和医学技术的发展,许多医疗中心开展了肺动脉血栓清除术,并强调对于血流动力学暂时稳定但伴有严重右心功能障碍的急性PE,应尽早在循环衰竭之前进行肺动脉血栓清除术。肺动脉血栓清除术是一种有效的治疗严重急性肺栓塞的治疗方式,在有条件的医疗中心,开展肺动脉血栓清除术可使急性肺栓塞病人获益。
[Abstract]:Acute pulmonary embolism is a common clinical emergency, with high incidence and high mortality. Pulmonary thrombus clearance has been used in the emergency treatment of severe acute pulmonary embolism, its status has been controversial. The present situation of pulmonary thrombus removal was discussed by reviewing the published literature on pulmonary thrombus clearance. The results showed that the mortality rate of pulmonary thrombus removal was decreasing. The cumulative mortality rate in recent years was 15.3D / 2010/ 2011/ 12.6 / 2012 / 2013) and 6.6 / 2014 / 2015) respectively. This trend confirms that pulmonary thrombus clearance is more and more effective than thrombolytic therapy in terms of early postoperative mortality, hemorrhage and recurrence of pulmonary congestion. Factors such as preoperative hemodynamics and cardiac arrest can significantly affect the prognosis of pulmonary thrombus clearance. With the continuous understanding of pulmonary embolism and the development of medical technology. Pulmonary artery thrombus clearance has been performed in many medical centers, with emphasis on acute PE with temporarily stable hemodynamics with severe right ventricular dysfunction. Pulmonary thrombus clearance should be performed as early as possible before circulation failure. Pulmonary thrombus clearance is an effective treatment for severe acute pulmonary embolism in conditional medical centers. Pulmonary thrombus removal can benefit patients with acute pulmonary embolism.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R655.3

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