Yoo Jung-Wan, Choi Ho Cheol, Lee Seung Jun, Cho Yu Ji, Lee Jong Deog, Kim Ho Cheol
Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea.
Department of Radiology, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea.
Am J Emerg Med. 2016 Jun;34(6):985-8. doi: 10.1016/j.ajem.2016.02.037. Epub 2016 Feb 15.
Although systemic thrombolysis (ST) or catheter-directed therapy (CDT) is performed in patients with acute massive or submassive pulmonary embolism (PE), clinical data comparing between both therapies remain limited. We compared clinical outcomes between ST and CDT in patients with acute massive and submassive PE.
From January 2005 to June 2015, clinical outcomes of patients with acute massive or submassive PE receiving ST or CDT were evaluated and compared retrospectively.
Of 72 patients, 44 were treated with ST; and 28, with CDT. The mean age was 63.9 ± 17 years old. The proportion of male sex was higher in patients receiving CDT compared to that with ST (46.4% vs 20.5%; P = .02). Half of patients presented with massive PE, and cardiac arrest occurred in 11 patients (15.3%). No difference was observed between the 2 groups with respect to 7-day mortality (13.6% in ST vs 10.7% in CDT), inhospital mortality (13.6% in ST vs 14.3% in CDT), and major bleeding complication (16.7% in ST vs 16.7% in CDT). Cardiac arrest (odds ratio, 6.286; 95% confidence interval, 1.081-36.555; P = .041) was associated with 14-day mortality.
Similar clinical outcomes were shown between ST and CDT in patients with acute massive or submassive PE.
尽管急性大面积或次大面积肺栓塞（PE）患者会接受全身溶栓治疗（ST）或导管定向治疗（CDT），但比较这两种治疗方法的临床数据仍然有限。我们比较了急性大面积和次大面积PE患者接受ST和CDT后的临床结局。
回顾性评估并比较2005年1月至2015年6月接受ST或CDT治疗的急性大面积或次大面积PE患者的临床结局。
72例患者中，44例接受ST治疗，28例接受CDT治疗。平均年龄为63.9±17岁。接受CDT治疗的患者中男性比例高于接受ST治疗的患者（46.4%对20.5%；P = 0.02）。一半的患者表现为大面积PE，11例患者（15.3%）发生心脏骤停。两组在7天死亡率（ST组为13.6%，CDT组为10.7%）、住院死亡率（ST组为13.6%，CDT组为14.3%）和严重出血并发症（ST组为16.7%，CDT组为16.7%）方面未观察到差异。心脏骤停（优势比，6.286；95%置信区间，1.081 - 36.555；P = 0.041）与第14天死亡率相关。
急性大面积或次大面积PE患者接受ST和CDT后的临床结局相似。
