[Choice of the method of thrombolytic therapy in massive pulmonary embolism].

Grudnaia khirurgiia (Moscow, Russia) Pub Date : 1989-05-01
V S Savel'ev, E G Iablokov, V N Il'in, A I Kirienko, S G Leont'ev
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Abstract

Analysis of the results of using fibrinolysis activators in 196 patients with massive embolism of the pulmonary arteries was undertaken to choose the optimum method of thrombolytic therapy. High doses of fibrinolysis activators (from 5,000,000 to 7,000,000 U) were used in 127 cases and low doses (from 125,000 to 3,000,000 U) in combination with heparin and disaggregating agents in the remaining 69 cases. A cava-filter was implanted in 161 patients before beginning treatment. Obvious advantages of thrombolytic therapy of massive pulmonary embolism with high doses of fibrinolysis activators were revealed in the process of treatment. They consist in quicker restoration of continuity of the pulmonary arteries, which leads to rapid removal of hypertension in pulmonary circulation and reduction of the number of deaths from acute cardiopulmonary failure. Treatment with such doses does not lead to an increase of the number of hemorrhagic complications, which makes possible surgical prevention of recurrent pulmonary embolism by cava-filter implantation.

【大规模肺栓塞溶栓治疗方法的选择】。
对196例肺动脉大栓塞患者使用纤溶活化剂的结果进行分析,选择最佳的溶栓治疗方法。高剂量的纤溶活化剂(500万至700万U)用于127例,低剂量(12.5万至300万U)联合肝素和分解剂用于其余69例。在开始治疗前,161名患者植入了腔静脉过滤器。在治疗过程中显示出大剂量纤溶活化剂溶栓治疗大面积肺栓塞的明显优势。它们包括更快地恢复肺动脉的连续性,从而迅速消除肺循环中的高血压,减少因急性心肺衰竭死亡的人数。这种剂量的治疗不会导致出血性并发症的增加,这使得通过腔静脉过滤器植入手术预防复发性肺栓塞成为可能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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