大规模的肺栓塞
Nils Kucher1, Elisa Rossi, Marisa De Rosa
1Cardiovascular Division, Department of Medicine, University Hospital Zurich, Zurich, Switzerland.
Circulation
|January 25, 2006
概括
大规模肺栓塞 (PE) 治疗结果显示,血栓溶解没有改善存活率,而下静脉膜 (IVC) 过器可能会降低死亡率. 需要进一步研究IVC过器在大量PE患者的疗效.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
背景情况:
- 急性大规模肺栓塞 (PE) 与高死亡率有关.
- 辅助疗法,如血栓溶解和下静脉膜 (IVC) 过器,用于大规模的PE管理.
- 了解这些疗法对临床结果的影响至关重要.
研究的目的:
- 为了研究使用血栓溶解和IVC过器放置在患有大量PE的患者.
- 评估这些辅助疗法对大量PE患者的临床结果的影响.
主要方法:
- 来自国际合作性肺栓塞病例登记 (ICOPER) 数据的分析.
- 包括2392名急性PE患者,确定108名 (4.5%) 患有大量PE (静脉压<90毫米升).
- 对接受血栓溶解,栓塞切除或IVC过器的患者与没有接受血栓溶解,栓塞切除或IVC过器的患者之间的结果进行比较.
主要成果:
- 大规模PE患者的90天死亡率为52.4%,而非大规模PE患者的死亡率为14.7%.
- 血栓溶解药物治疗没有显著降低90天死亡率 (46.3%对55.1%) 或复发性PE率 (12%对12%).
- 下腔静脉 (IVC) 过器的放置与90天死亡率 (危险比率,0.12) 的降低有关,并且没有复发性PE事件.
结论:
- 在ICOPER中,三分之二的大量PE患者没有接受血栓溶解或栓塞切除.
- 血栓溶解没有显示出死亡率的好处或90天后复发性PE的减少.
- 与IVC过器相关的潜在死亡率降低需要进一步调查.
相关概念视频
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