Cabrera Fischer E I, Willshaw P, de Forteza E, Biagetti M, Altman R, Morales M C, Pichel R H, Favaloro R G
J Thorac Cardiovasc Surg. 1987 Apr;93(4):620-7.
Massive acute pulmonary thromboembolism has a high mortality within the first few hours. Surgical intervention can remove only larger thrombi. Systemic fibrinolytic administration requires many hours for adequate treatment. We describe an anesthetized dog model of acute, massive, disseminated pulmonary thromboembolism achieved by injection of 1.7 ml/kg of 1-hour-old thrombi directly into the pulmonary artery. The emboli were lysed with 50,000 IU streptokinase recirculated for 20 minutes through the isolated pulmonary vascular bed by use of a roller pump while the systemic bed was supported by conventional cardiopulmonary bypass. On reestablishing natural circulation all hemodynamic parameters returned to preembolism values. Success of lysis was histologically confirmed. Perfusion of the pulmonary vascular bed without inclusion of streptokinase in the perfusate worsened the hemodynamic state of the animals compared with an untreated nonperfused control group.
大面积急性肺血栓栓塞症在最初几小时内死亡率很高。外科干预只能清除较大的血栓。全身纤维蛋白溶解剂给药需要数小时才能达到充分治疗效果。我们描述了一种急性、大面积、播散性肺血栓栓塞症的麻醉犬模型，通过将1.7毫升/千克1小时龄的血栓直接注入肺动脉来实现。使用滚压泵将50000国际单位链激酶通过隔离的肺血管床再循环20分钟以溶解栓子，同时通过传统体外循环支持体循环。恢复自然循环后，所有血流动力学参数均恢复到栓塞前值。溶栓成功通过组织学证实。与未治疗的非灌注对照组相比，在灌注液中不加入链激酶的情况下灌注肺血管床会使动物的血流动力学状态恶化。
