急性肺栓塞切除术:一种现代的方法
Lishan Aklog1, Christopher S Williams, John G Byrne
1Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
Circulation
|March 27, 2002
概括
手术性肺栓塞切除提供了广泛的肺栓塞与右心室功能障碍的高生存率. 这种方法自由化了标准,超越了为改善患者结果的最后手段治疗.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 尽管诊断和治疗方面取得了进展,但急性肺栓塞 (PE) 的死亡率很高.
- 对于PE的血栓溶解是有效的,但具有显著的出血风险,特别是内出血.
- 对于患有广泛疾病和右心室功能障碍的PE患者,肺栓塞术的自由化标准被采用.
研究的目的:
- 评估一组选定的患者手术肺栓塞术的结果.
- 评估肺栓塞切除术的可行性和有效性,超出其作为最后手段的传统作用.
主要方法:
- 在1999年10月至2001年10月期间,连续29名患者接受肺栓塞术的回顾性分析.
- 包括标准涉及解剖学上广泛的PE与中度至严重的右心室功能障碍,尽管系统性动脉压力保持.
主要成果:
- 在29名患者中,有26名 (89%) 患者在手术后幸存下来,并在术后活了超过一个月.
- 研究队列的中位数随访时间为10个月.
结论:
- 通过改进的手术技术,快速诊断和仔细的患者选择,实现了89%的高生存率.
- 肺栓塞术应该被认为是一个可行的治疗选择,在一个更广泛的算法管理急性肺栓塞.
- 这项研究表明,肺栓塞术可以在精心挑选的患者中安全地使用,而不仅仅是在关键的末期情景中.
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