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【medical-news】经皮血栓切除术：部分肺栓塞的一
NEW YORK (Reuters Health) Jul 29 - Combined clot fragmentation and thrombus aspiration appears to be beneficial in certain patients with massive angiographic pulmonary embolism (PE), according to Mexican researchers.
Percutaneous mechanical thrombectomy (PMT), lead investigator Dr. Guering Eid-Lidt told Reuters Health, "is an alternative therapy for patients with massive PE or acute PE associated with right ventricular dysfunction unresponsive to the optimal treatment with IV heparin, saline solution, vasoactive catecholamines, and systemic thrombolysis, and in patients with contraindications to systemic thrombolysis, increased bleeding risk or unavailable surgical thrombectomy."
In the July issue of Chest, Dr. Eid-Lidt and colleagues at Instituto Nacional de Cardiologia "Ignacio Chavez," Mexico City, report on their study involving 18 patients with massive PE.
All underwent thrombus fragmentation using a pigtail catheter and 13 also had thrombus aspiration. A percutaneous thrombectomy device (Aspirex, Straub Medical) was employed in 11 patients.
Following the procedure, there was a significant increase in systolic systemic BP and a significant decrease in mean pulmonary artery pressure.
One in-hospital death occurred, attributed to PE, and another patient had intracerebral hemorrhage with minor neurological sequelae. However, during more than a year of follow-up, there were no cardiovascular deaths or recurrent pulmonary thromboembolism.
"The main objective of the treatment in patients with massive PE is to reduce right ventricular afterload and increase the systemic blood pressure," added Dr. Eid-Lidt. "PMT performed in highly qualified centers can improve the hemodynamic instability, because it has the potential benefit of quickly reversing the right ventricular dysfunction."
In an accompanying editorial, Dr. Samuel Z. Goldhaber of Brigham and Women's Hospital, Boston and Dr. Nils Kucher of University Hospital Zurich, call the results "convincing" but they also point out that the study was small and that pulmonary artery interventions have the potential for fatal complications.
They therefore recommend that the procedure "should be reserved for PE patients at high risk of death from right ventricular failure."
Chest 2008;134:54-60. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Percutaneous Thrombectomy an Option in Some Cases of Pulmonary Embolism
一些肺栓塞病例的治疗选择：经皮血栓切除术
NEW YORK (Reuters Health) Jul 29 - Combined clot fragmentation and thrombus aspiration appears to be beneficial in certain patients with massive angiographic pulmonary embolism (PE), according to Mexican researchers.
纽约（路透社 健康）７月２９日－据墨西哥研究者报告，对于血管造影显示大块肺栓塞的特定患者联合血栓破碎和栓子吸除治疗呈现出良好的结果。
Percutaneous mechanical thrombectomy (PMT), lead investigator Dr. Guering Eid-Lidt told Reuters Health, "is an alternative therapy for patients with massive PE or acute PE associated with right ventricular dysfunction unresponsive to the optimal treatment with IV heparin, saline solution, vasoactive catecholamines, and systemic thrombolysis, and in patients with contraindications to systemic thrombolysis, increased bleeding risk or unavailable surgical thrombectomy."
（该项目的）主要研究者Guering Eid-Lidt博士告诉路透社健康版的记者说：“对于大块肺栓塞的患者和与右心室功能衰竭相关的急性肺栓塞，而又对肝素，扩容，血管活性药儿茶酚胺，和全身溶栓治疗不敏感，和全身溶栓治疗禁忌，出血风险增高或无法行血栓切除手术的患者，经皮机械血栓切除术(PMT)是一个备选的治疗方案。”
In the July issue of Chest, Dr. Eid-Lidt and colleagues at Instituto Nacional de Cardiologia "Ignacio Chavez," Mexico City, report on their study involving 18 patients with massive PE.
All underwent thrombus fragmentation using a pigtail catheter and 13 also had thrombus aspiration. A percutaneous thrombectomy device (Aspirex, Straub Medical) was employed in 11 patients.
在Ｃｈｅｓｔ７月期上，墨西哥城Instituto Nacional de Cardiologia "Ignacio Chavez,"的Eid-Lidt博士和他的同事报道了他们对１８例大块肺栓塞患者的研究。所有的患者都接受了应用猪尾导管的血栓破碎治疗并且１３例予以血栓吸除。一种经皮血栓切除术的设备(Aspirex, Straub Medical)在１１例患者身上应用。
Following the procedure, there was a significant increase in systolic systemic BP and a significant decrease in mean pulmonary artery pressure.
完成操作后，患者的全身收缩压显著身高并且肺动脉压显著降低。
One in-hospital death occurred, attributed to PE, and another patient had intracerebral hemorrhage with minor neurological sequelae. However, during more than a year of follow-up, there were no cardiovascular deaths or recurrent pulmonary thromboembolism.
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作者:admin@医学,生命科学 2010-10-02 05:11
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