[Assessment of treatment regimens in 58 cases with acute pulmonary embolism]

To explore the best regimen of treatment for acute pulmonary embolism(APE), and to evaluate the efficacy and safety of 2-h infusion of recombinant tissue-type plasminogen activator, Alteplase (rt-PA) and urokinase(UK).

Fifty-eight patients with APE diagnosed by perfusion lung scanning (ECT) or angiography(CPA) were treated with different regimens: i.e. 2-h infusion of rt-PA or UK (2-h group); low doses of UK for 3-7 days (Qd group); anticoagulants alone and thromboectomy. The results were compared.

Of the 41 patients treated with thrombolytic therapy 78% showed improvement in lung perfusion scan and clinical presentation without severe adverse effects, the percentage was significantly higher than that of the anticoagulant group(P < 0.001). The rate of improvement was 84% if thrombolytic therapy was given in 2 h. The mortality rate was lower than anticoagulants and thromboectomy group. The success rate of thromboectomy was 40%.

A 2 h regimen of rt-PA or UK showed reliable efficacy and safety for treatment of APE. The indication of thrombolytic therapy can be extended. Mortality and morbidity could be reduced if thrombolytic therapy followed by anticoagulation is applied as early as possible.