低剂量溶栓剂成功治疗急性危及生命的大面积肺血栓栓塞症患者：一例报告
Successful thrombolysis with low dose thrombolytic agent in a patient with acute life-threatening massive pulmonary thromboembolism: A case report.
作者信息
Adhikari Sagar, Vaidya Nirish, Poudel Priyanka, Pathak Sujan
机构信息
Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, 45210, Nepal.
Pulmonary Unit, Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, 45210, Nepal.
出版信息
Ann Med Surg (Lond). 2022 Sep 22;82:104742. doi: 10.1016/j.amsu.2022.104742. eCollection 2022 Oct.
INTRODUCTION
and importance: Acute massive pulmonary thromboembolism is a potentially life-threatening condition requiring urgent management to decrease mortality. Although the standard dose of systemic thrombolysis with alteplase is 100 mg, half the dose of alteplase can be used to break up clots successfully, especially if bleeding is a concern.
CASE PRESENTATION
We report a case of massive pulmonary thromboembolism presenting with cardiopulmonary arrest, successfully managed with advanced cardiac life support, anticoagulants, and low-dose thrombolytics.
CLINICAL DISCUSSION
Management of massive pulmonary thromboembolism includes medical thrombolysis along with maintenance of hemodynamic stability. Our patient was successfully managed with low-dose thrombolytics and was continued with standard oral anticoagulants for 6 months.
CONCLUSION
In patients of acute massive pulmonary thromboembolism, a low dose of the thrombolytic agent can achieve complete resolution of the thrombus with less bleeding risk.
引言
及重要性：急性大面积肺血栓栓塞症是一种潜在的危及生命的疾病，需要紧急处理以降低死亡率。虽然阿替普酶全身溶栓的标准剂量是100毫克，但阿替普酶剂量减半也可成功溶解血栓，尤其是在担心出血的情况下。
病例介绍
我们报告一例大面积肺血栓栓塞症患者，该患者出现心脏骤停，通过高级心脏生命支持、抗凝剂和低剂量溶栓剂成功治疗。
临床讨论
大面积肺血栓栓塞症的治疗包括药物溶栓以及维持血流动力学稳定。我们的患者通过低剂量溶栓剂成功治疗，并继续使用标准口服抗凝剂6个月。
结论
在急性大面积肺血栓栓塞症患者中，低剂量溶栓剂可在降低出血风险的情况下使血栓完全溶解。
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