RESUMO
Objective To study the different curative effect between r-tPA application and urokinase in the interventional therapy for acute and severe pulmonary embolism.Methods Analyzed the clinical date of 22 cases acute and severe pulmonary embolism patients,and classified them into two groups according to the application of r-tPA and urokinase to compare the changes of their blood pressure,heart rate,arterial partial pressure of oxygen,hemachrome and pulmonary arterial pressure before and after therapy,meanwhile,record the thrombolysis time that the two groups took.Results The thrombolysis effect time adopting urokinase was remarkably longer than that thrombolysis adopting r-tPA(P<0.05); The blood pressure,heart rate,arterial partial pressure of oxygen of the two groups gained remarkable improvement after therapy(P<0.05).The pulmonary arterial pressure of the urokinase group dropped obviously after operation(P<0.05),while the r-tPA group dropped not so significantly after operation.The hemachrome of the two groups did not dropped significantly after operation.Conclusion The r-tPA and urokinase are both effective to interventional therapy for acute and severe pulmonary embolism,while r-tPA can clearly shorten the time in thrombolysis and could reduce any bleeding risk.
RESUMO
Objective To evaluate the clinical effect and safety of transcatheter thrombus-breaking combined with local infusion of reteplase (rPA) in treating severe pulmonary thromboembolism (PTE). Methods During the period from June 2010 to June 2013 at authors’ hospital, transcatheter thrombus-breaking combined with local infusion of reteplase was carried out in 26 patients (17 males and 9 females) with severe pulmonary embolism. The changes of pulmonary circulation and the cardio - pulmonary hemodynamics after the treatment were analyzed. Results The preoperative mean pulmonary artery pressure, arterial blood oxygen partial pressure and the blood pressure were (63.78 ± 6.89) mmHg, (73.23 ± 11.51) mmHg and (87.35 ± 10.92) mmHg respectively, while the postoperative ones were (26.23 ± 10.27) mmHg, (93.48 ± 6.17) mmHg and(127.14 ± 13.15) mmHg respectively, and the differences between preoperative and postoperative ones were statistically significant (P<0.01). All the patients were followed up for 6 - 36 months. Significant stable clinical improvement was obtained in 25 patients, and recurrence was seen in one patient. Conclusion Transcatheter thrombus-breaking combined with local infusion of reteplase can quickly improve the pulmonary circulation and the clinical conditions for patients with severe pulmonary thromboembolism, and it has no obvious complications. This technique carries excellent value in maintaining the stability of hemodynamics.
