本文關(guān)鍵詞： 急性肺栓塞 肺動脈血栓清除術(shù) 手術(shù)治療　出處：《重慶醫(yī)科大學》2016年碩士論文　論文類型：學位論文

【摘要】：急性肺栓塞是一種常見臨床急診,具有高發(fā)病率和高病死率。肺動脈血栓清除術(shù)一直以來用于嚴重急性肺栓塞的緊急搶救治療,其地位一直伴有爭議,本文通過查閱已發(fā)表的關(guān)于肺動脈血栓清除術(shù)的文獻,探討肺動脈血栓清除術(shù)的現(xiàn)狀。結(jié)果顯示肺動脈血栓清除術(shù)的死亡率呈下降趨勢,近年來累計死亡率分別為15.3%(2010~2011)、12.6%(2012~2013)和6.6%(2014~2015),這種趨勢證實肺動脈血栓清除術(shù)具有越來越好的臨床療效。與溶栓治療相比,肺動脈血栓清除術(shù)在術(shù)后早期死亡率、出血及肺塞復(fù)發(fā)方面,具有低于溶栓治療的趨勢。術(shù)前血流動力學狀態(tài)和術(shù)前心臟驟停等因素可顯著影響肺動脈血栓清除術(shù)的預(yù)后。隨著對肺栓塞的不斷認識和醫(yī)學技術(shù)的發(fā)展,許多醫(yī)療中心開展了肺動脈血栓清除術(shù),并強調(diào)對于血流動力學暫時穩(wěn)定但伴有嚴重右心功能障礙的急性PE,應(yīng)盡早在循環(huán)衰竭之前進行肺動脈血栓清除術(shù)。肺動脈血栓清除術(shù)是一種有效的治療嚴重急性肺栓塞的治療方式,在有條件的醫(yī)療中心,開展肺動脈血栓清除術(shù)可使急性肺栓塞病人獲益。
[Abstract]:Acute pulmonary embolism is a common clinical emergency, with high incidence and high mortality. Pulmonary thrombus clearance has been used in the emergency treatment of severe acute pulmonary embolism, its status has been controversial. The present situation of pulmonary thrombus removal was discussed by reviewing the published literature on pulmonary thrombus clearance. The results showed that the mortality rate of pulmonary thrombus removal was decreasing. The cumulative mortality rate in recent years was 15.3D / 2010/ 2011/ 12.6 / 2012 / 2013) and 6.6 / 2014 / 2015) respectively. This trend confirms that pulmonary thrombus clearance is more and more effective than thrombolytic therapy in terms of early postoperative mortality, hemorrhage and recurrence of pulmonary congestion. Factors such as preoperative hemodynamics and cardiac arrest can significantly affect the prognosis of pulmonary thrombus clearance. With the continuous understanding of pulmonary embolism and the development of medical technology. Pulmonary artery thrombus clearance has been performed in many medical centers, with emphasis on acute PE with temporarily stable hemodynamics with severe right ventricular dysfunction. Pulmonary thrombus clearance should be performed as early as possible before circulation failure. Pulmonary thrombus clearance is an effective treatment for severe acute pulmonary embolism in conditional medical centers. Pulmonary thrombus removal can benefit patients with acute pulmonary embolism.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R655.3

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本文編號：1468222