我们应该在何时对肺栓塞患者进行溶栓治疗？一项文献系统综述。
When should we thrombolyse patients with pulmonary embolism? A systematic review of the literature.
作者信息
Harris T, Meek S
机构信息
Royal Melbourne Hospital, Australia.
出版信息
Emerg Med J. 2005 Nov;22(11):766-71. doi: 10.1136/emj.2003.011965.
Abstract
The early mortality in pulmonary embolism (PE) is largely predicted by the associated cardiovascular response, with progressive right ventricular failure, hypotension, shock, and circulatory arrest being associated with increasing mortality. Thrombolysis may improve the prognosis of PE associated with these varying degrees of circulatory collapse, but has no place in the treatment of small emboli with no cardiovascular compromise, as it carries a significant risk of haemorrhage. This review sets out to guide the emergency physician in deciding which patients with PE may benefit from thrombolysis.
摘要
肺栓塞（PE）的早期死亡率很大程度上由相关的心血管反应预测，进行性右心室衰竭、低血压、休克和循环骤停与死亡率增加相关。溶栓可能改善与这些不同程度循环衰竭相关的PE的预后，但在治疗无心血管功能损害的小栓子方面没有作用，因为它有显著的出血风险。本综述旨在指导急诊医生决定哪些PE患者可能从溶栓中获益。
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本文引用的文献
1
Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial.抗凝药物治疗肺栓塞的对照试验。
Lancet. 1960 Jun 18;1(7138):1309-12. doi: 10.1016/s0140-6736(60)92299-6.
2
British Thoracic Society guidelines for the management of suspected acute pulmonary embolism.英国胸科学会疑似急性肺栓塞管理指南。
Thorax. 2003 Jun;58(6):470-83. doi: 10.1136/thorax.58.6.470.
3
Thrombolysis vs heparin in the treatment of pulmonary embolism: a clinical outcome-based meta-analysis.溶栓治疗与肝素治疗肺栓塞的疗效比较：基于临床结局的荟萃分析
Arch Intern Med. 2002;162(22):2537-41. doi: 10.1001/archinte.162.22.2537.
4
Thrombolytic therapy of pulmonary embolism: a meta-analysis.
J Am Coll Cardiol. 2002 Nov 6;40(9):1660-7. doi: 10.1016/s0735-1097(02)02381-1.
5
Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism.肝素联合阿替普酶与单用肝素治疗亚大面积肺栓塞患者的比较。
N Engl J Med. 2002 Oct 10;347(15):1143-50. doi: 10.1056/NEJMoa021274.
6
Acute pulmonary embolectomy: a contemporary approach.
Circulation. 2002 Mar 26;105(12):1416-9. doi: 10.1161/01.cir.0000012526.21603.25.
7
Mechanical and enzymatic thrombolysis for massive pulmonary embolism.大面积肺栓塞的机械性和酶性溶栓治疗
J Vasc Interv Radiol. 2002 Feb;13(2 Pt 1):163-9. doi: 10.1016/s1051-0443(07)61933-2.
8
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