大規模な肺栓塞症である
Nils Kucher1, Elisa Rossi, Marisa De Rosa
1Cardiovascular Division, Department of Medicine, University Hospital Zurich, Zurich, Switzerland.
Circulation
|January 25, 2006
まとめ
大量の肺栓塞 (PE) 治療の結果は,血栓溶解が生存率を向上させなかったことを示すが,下静脈 (IVC) フィルターは死亡率を低下させる可能性がある. 大量のPE患者におけるIVCフィルターの有効性については,さらなる研究が必要である.
科学分野:
- 心臓病学 心臓病学
- 肺内医学 肺内医学 肺内医学
- クリティカルケア・メディシン
背景:
- 急性多発性肺栓塞 (PE) は,高い死亡率と関連しています.
- トロンボリシスや下静脈穴 (IVC) フィルターなどの補助療法が,大規模なPE管理に使用されます.
- これらの治療法が臨床結果に与える影響を理解することは極めて重要です.
研究 の 目的:
- 大量のPE患者における血栓溶解とIVCフィルター配置の利用を調査する.
- これらの補助療法の効果を大量PE患者の臨床結果に評価する.
主な方法:
- 国際協同肺栓塞症レジストリ (ICOPER) のデータ分析.
- 急性PE患者の2392人を含め,108人 (4.5%) が大規模なPE (静脈動脈圧<90mmHg) を特定しました.
- 血栓溶解,エンボレクトミー,またはIVCフィルターを投与された患者と,投与されなかった患者との間のアウトカムの比較.
主要な成果:
- 大量のPE患者では90日間の死亡率は52.4%で,大量のPEでない患者では14.7%でした.
- 血栓駆除薬療法は90日間の死亡率 (46.3%対55.1%) や再発性PE率 (12%対12%) を有意に低下させなかった.
- 下腔静脈 (IVC) フィルター配置は90日間の死亡率の低下 (危険比0.12) と再発性PEイベントの欠如と関連していました.
結論:
- ICOPERの大規模なPE患者の3分の2は,血栓溶解や栓切除術を受けませんでした.
- 血栓溶解は,死亡率の利益または90日後に再発性PEの減少を示さなかった.
- IVCフィルターに関連した潜在的な死亡率の減少は,さらなる調査を正当化します.
関連する概念動画
01:26Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
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