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单边慢性血栓栓塞性肺病:患者是否受益于血栓内切除术? 来自三个CTEPH中心的案例系列

Farid Rashidi¹, Bedrettin Yıldızeli², Rezayat Parvizi³

¹Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Heart, lung & circulation

|September 20, 2024

概括

肺内关节切除术 (PEA) 有效地治疗罕见的单边慢性血栓栓塞性肺病 (CTEPD),改善患者的症状和血液动力学. 这种程序为符合条件的患有这种疾病的患者提供了安全和有益的选择.

科学领域:

心脏病学心脏病学
肺部医学肺部医学
胸部外科手术胸部外科手术

背景情况:

单边慢性血栓栓塞性肺病 (CTEPD) 是一种罕见的疾病,对治疗结果的数据有限.
肺内关节切除术 (PEA) 是CTEPD的一种手术选择,但其在单方面病例中的疗效尚未得到充分证实.

研究的目的:

调查肺内关节切除术 (PEA) 在单边慢性血栓栓塞性肺病 (CTEPD) 患者的安全性和有效性.

主要方法:

一项多中心研究涉及来自美国,土耳其和伊朗的单边CTEPD患者.
评估人口统计数据,6分钟步行测试距离 (6MWD),纽约心脏协会 (NYHA) 功能类和血液动力学参数.

主要成果:

在1,031名PEA患者中,有39名 (3.7%) 患有单边CTEPD. 在平均肺动脉压 (mPAP) 和肺血管阻力 (PVR) 中观察到显著改善.
在PEA后,NYHA功能类和6MWD显示显著改善 (p<0.001).
具有正常出血动力学的患者在6MWD,mPAP或PVR中没有显著变化. 侧流是最常见的并发症;在1年的随访期间没有死亡.

结论:

肺内关节切除术 (PEA) 是单方面CTEPD的安全有效的治疗方法,导致症状和血液动力学改善.
诊断为单边慢性血栓栓塞性疾病的症状患者是PEA的合适候选人.

关键词:

在CTEPH的基础上,慢性血栓栓塞性肺高血压慢性血栓塞性肺高血压慢性血栓塞栓症肺部疾病肺部疾病进行血栓内切除术 (Thromboendarterectomy).单边权益是一种单边权益.

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