ABSTRACT
Objective To explore the effect of intracavitary therapy on acute pulmonary embohsm.Methods Fifteen patients were selected as our subjects,who suffered acute pulmonary embolism and received percutaneous catheter thrombus crashing and catheter directed thrombolysis in Beijing Military.Region General Hospital from January 2009 to June 2011.Local injection of Urokinase was performed with a total amount of 500 000 U in catheter directed thrombolysis.After thrombolysis,low molecular Heparin was administered to patients for 7-10 days and oral administration of Warfarin was performed for 3-6 months.Clinical symptoms,improvement of physical signs,complications,changes of mean pulmonary arterial pressure(mPAP) and arterial partial pressure of oxygen(PO2),and the opening of pulmonary artery were recorded.Results The pulmonary arteries of the 12 patients were completely opened,and partially opened in 3 patients.The effective rate was 100％ (15/15).mPAP was reduced from (40.07 ±5.97) mmHg to (20.00 ±4.66) mmHg (t =-1.128,P ＜ 0.05),PO2 was increased from (50.26 ± 9.30) mmHg to (80.49 ± 9.04) mmHg (t =1.246,P ＜ 0.05).Patients were followed-up for 3-6 months and no recurrence case was seen.Conclusion The interventional therapy is effective,safe and practicable in the treatment of acute pulmonary embolism.
ABSTRACT
Objective To summarize the experience on the diagnosis and therapy of intravenous leiomyomatosis(IVL)of the inferior vena cava.Methods Eight IVL patients were treated in our hospital from March 1998 to April 2007. Results The diagnosis of IVL of the inferior vena cava was established histologically by biopsy during inferior vena eavagram before operation in 4 patients.Seven patients received open surgery.Except one patient dying of massive hemorrhage during operation and one IVL recurrence during follow-up,postoperative course was uneventful and an average follow-up of 29 months found no recurrence in the other five patients. Conclusion The final diagnosis of IVL of the inferior vena cava depends on venogram and biopsy,and it is an estrogen dependent tumor originating from uterus leiomyoma.Total surgical extirpation of the tumor is the only effective treatment for IVL.