Steuer Johnny, Ivert Terbjörn, Johnsson Hans
Institutionen för kirurgiska vetenskaper, Akademiska sjukhuset, Uppsala, Sweden.
Lakartidningen. 2004 Oct 28;101(44):3422-4, 3427.
Acute pulmonary embolism occurs in about 10,000 people annually in Sweden, in more than 1000 of whom it has a fatal outcome. The clinical presentation may vary considerably, and a large number of patients with pulmonary embolism are still misdiagnosed. Most patients are treated with anticoagulants and some also with thrombolysis. During a 40-year period, 1957-1996, 12 patients underwent emergency pulmonary embolectomy at the Karolinska Hospital in Stockholm, Sweden. Of these, two (17%) died from anoxic brain damage within the first postoperative month. Four patients died 15-21 years after surgery. Six patients who were still alive at follow-up in 2003 were contacted 7-36 years after the embolectomy and were all in good health. In none of them had pulmonary embolism recurred, but two had suffered deep venous thrombosis. We conclude that emergency pulmonary embolectomy can be a lifesaving procedure, with a good long-term prognosis in patients who survive the early perioperative period.
在瑞典，每年约有10000人发生急性肺栓塞，其中1000多人会因此死亡。临床表现可能差异很大，大量肺栓塞患者仍被误诊。大多数患者接受抗凝治疗，部分患者还接受溶栓治疗。在1957年至1996年的40年期间，瑞典斯德哥尔摩卡罗林斯卡医院有12例患者接受了急诊肺动脉血栓切除术。其中，2例（17%）在术后第一个月内因缺氧性脑损伤死亡。4例患者在术后15至21年死亡。2003年随访时仍存活的6例患者在血栓切除术后7至36年被联系，他们均健康状况良好。他们中没有一例肺栓塞复发，但有2例发生了深静脉血栓形成。我们得出结论，急诊肺动脉血栓切除术可以挽救生命，对于在围手术期早期存活的患者，长期预后良好。
