转移中的血块:死亡原因还是旁观者?
Al-Zahraa Almahlawi1,2,3, Mohammad Alghamdi2,4,3,3, Mutaz Althobaiti1,2,3
1Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Journal of the Saudi Heart Association
|June 16, 2023
概括
转移中的血块,这是血栓栓塞性疾病的罕见表现,在治疗的第一个星期没有与糟糕的结果直接相关. 然而,只有26%的患者在治疗四周内实现了完全的凝块分离.
科学领域:
- 心脏病学 心脏病学
- 血栓塞栓性疾病 血栓塞栓性疾病
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 转移中的血块是血栓栓塞性疾病的罕见但严重的表现,通常与肺栓塞 (PE) 相关,并与预后不佳有关.
- 运输中的血块的最佳治疗策略仍然不成熟,需要进一步研究有效的管理和结果.
研究的目的:
- 描述诊断出在转移中的血块的患者的治疗干预和结果.
- 分析一组患有右心瘤的患者的特征和治疗反应.
主要方法:
- 在2016年1月至2020年12月期间,通过心声图进行了对35名通过心声图诊断出患有血栓的患者的回顾性图表审查.
- 包括心声学证据显示右心瘤的患者,但不包括那些有瘤,植被或细菌病的患者. 分析了同时使用CT胸部和心声回声图的数据.
主要成果:
- 80%的患者在治疗4周后显示出部分或全部的血块解脱. 肝素是主要的初始治疗 (74%),其次是华法林 (51.4%).
- 虽然26%的患者在28天内死亡,但7天死亡率仅为6%. 在患有右心室缩压升高 (RVSP>50 mmHg) 的患者中,死亡率更高,需要氧气或内支持.
- 在66%的病例中观察到移动性血栓,在17%的病例中观察到右心室 (RV) 菌株,在74%的病例中观察到异常RVSP (>30 mmHg).
结论:
- 在这个队列中,转移中的血块与治疗的第一个星期内的不良结果没有直接关联.
- 未分离的肝素 (UFH) 仍然是最常见的初始治疗方法,但四周内整体缓解率低于最佳水平,为26%.
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