静脉溶栓成功治疗静脉-动脉体外膜肺氧合合并左心室血栓：一例报告
Successful treatment of veno-arterial extracorporeal membrane oxygenation complicated with left ventricular thrombus by intravenous thrombolysis: A case report.
作者信息
Wang Ya-Dong, Lin Jin-Feng, Huang Xiao-Ying, Han Xu-Dong
机构信息
Intensive Care Medicine, Nantong Third People's Hospital, Nantong 226000, Jiangsu Province, China.
Critical Care Medicine, Nantong Third People's Hospital, Nantong 226000, Jiangsu Province, China.
出版信息
World J Clin Cases. 2023 May 16;11(14):3323-3329. doi: 10.12998/wjcc.v11.i14.3323.
BACKGROUND
Left ventricular thrombus is a rare condition, for which appropriate treatments are not extensively studied. Although it can be treated by thrombectomy, such surgery can be difficult and risky, and not every patient can tolerate the surgery.
CASE SUMMARY
We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation. After systemic thrombolysis with urokinase, the left ventricular thrombus disappeared, ECMO was successfully withdrawn 9 days later, and the patient recovered and was discharged from hospital.
CONCLUSION
Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.
背景
左心室血栓是一种罕见病症，针对其的适当治疗方法尚未得到广泛研究。尽管可以通过血栓切除术进行治疗，但这种手术可能困难且有风险，并非每个患者都能耐受该手术。
病例摘要
我们报告一例中年男性，因急性心肌梗死接受静脉-动脉体外膜肺氧合（VA-ECMO）治疗，尽管进行了全身抗凝治疗仍发生了左心室血栓。在用尿激酶进行全身溶栓后，左心室血栓消失，9天后成功撤掉ECMO，患者康复出院。
结论
除抗凝和血栓切除术外，全身溶栓也是左心室血栓的一种治疗选择。
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