摘要
Abstract
Objective To investigate the changes of hemodynamics during interventional treatment of acute massive pulmonary embolism ( MPE) .Methods From January 2012 to 2015 March, 106 cases admitted to the ICU with MPE were enrolled, according to the random number table method , they were randomly divided into two groups , the monitoring group (n =53) and control group ( n =53).All patients were treated with intravenous thrombolysis , the monitoring group and the control group was used hemodynamic monitoring and ultrasound echocardiography to assess the efficacy of thrombolytic thera -py, and changed to interventional therapy if needed .To compare the therapeutic effect of 2 groups, the blood flow dynamics, blood gas index and 28 d mortality rate after thrombolysis were recorded and analyzed .Results In monitoring group , 29 cases after 12 h were changed to intervention therapy , in the control group , 23 patients after 24 h were changed to intervention thera-py, the interventional treatment’s total efficiency were 96.6%and 82.6% respectively (χ2 =2.87, P >0.05); and com-pared to 0 h, 12 and 24 h after thrombolysis, two groups’ MAP, CVP, RVEF were significantly increased , PASP were de-creased ( P <0.05), 12 and 24 h after thrombolysis, the monitoring group’ s RVEF significantly increased, PASP de-creased, which were significantly different from the control group ( P <0.05);compared with 0 h, 24 h after thrombolysis, 2 groups’ PO2/FiO2,PO2,PCO2 were significantly improved ( P <0.05), 12 h after thrombolysis, the monitoring group’s PO2/FiO2, and 24 h after thrombolysis, the monitoring group’s PO2/FiO2 and PO2,PCO2 were significantly better than the control group ( P <0.05);follow-up for six months, the two groups’ 28 d mortality differences were not statistically signifi-cant ( P >0.05).Conclusion Hemodynamic monitoring for drug thrombolysis and guidance for early intervention can help to relieve pulmonary hypertension , improve right ventricular function .关键词
肺栓塞,大面积,急性/血流动力学监测/介入治疗Key words
Acute massive pulmonary embolism/Hemodynamics monitoring/Interventional therapy
