机械血栓切除术用于肺移植接受者的急性肺栓塞
Ana Glavan1, Shruti K Gadre2, Ihab Haddadin3
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
概括
机械血栓切除术 (MT) 为肺移植患者肺栓塞 (PE) 提供了一个有前途的治疗方法. 这种程序有效地去除了血栓,在一个小研究小组中改善了患者的治疗结果和生存率.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 移植手术 移植手术
背景情况:
- 肺栓塞 (PE) 是接受肺移植 (LT) 患者的重大并发症.
- 由于高出血风险和标准风险评估工具的局限性,在这些患者中管理PE很困难.
研究的目的:
- 评估机械血栓切除术 (MT) 在接受肺移植患者中治疗PE的可行性和有效性.
主要方法:
- 对8名接受过机械血栓切除术的肺移植患者进行了回顾性分析,以中等/高风险的近端PE.
- 在诊断后30小时内进行了成功的MT,涉及凝块脱以恢复血液流动.
主要成果:
- 所有8名患者都接受了成功的MT,估计血液损失在200-450cc之间; 3人需要输血.
- 所有患者在手术后的心率和氧化率立即有所改善.
- 30天的生存率为87.5% (8名患者中有7人);在MT后16天,由于严重出血发生了一例死亡.
结论:
- 机械血栓切除似乎是一个可行的和有效的管理策略,选择肺移植接受者经历肺栓塞.
- 在这种高风险患者群体中,MT可快速恢复流动并改善临床参数.
相关概念视频
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
Pulmonary Embolism I: Introduction
7
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
7


