Hall R J, Sutton G C, Kerr I H
Br Heart J. 1977 Oct;39(10):1128-34. doi: 10.1136/hrt.39.10.1128.
Seventy-two patients surviving initial treatment by pulmonary embolectomy, streptokinase, or heparin for acute massive pulmonary embolism have been reviewed 1 to 9 years later. Of these patients, 17 had additional cardiorespiratory disease. There were 12 late deaths (41% of those patients with, and 9% of those patients without additional cardiorespiratory disease). No death was due to chronic pulmonary hypertension, and none to certain recurrence of pulmonary embolism. The causes of death were malignant disease (6 patients), cardiopulmonary disease other than pulmonary embolism (4 patients), and 'sudden' (2 patients). Though venous interruption surgery was not used, and long-term anticoagulation rare, the incidence of possible or probable recurrent embolism was low (6%). There was no definite evidence of persistence or subsequent development of pulmonary hypertension after treatment in any patient. Resolution of embolism as judged by symptoms, signs, electrocardiogram, and chest x-ray examination was almost always complete. Some pulmonary arteriograms 1 to 6 months after initial treatment showed minor abnormalities, but others at a later date were normal. Perfusion lung scans carried out 1 to 8 years after initial treatment often showed minor abnormalities.
对72例接受过肺动脉血栓切除术、链激酶治疗或肝素治疗的急性大面积肺栓塞初始治疗存活患者进行了1至9年的随访。这些患者中，17例患有其他心肺疾病。有12例晚期死亡（占合并其他心肺疾病患者的41%，未合并其他心肺疾病患者的9%）。没有死亡是由于慢性肺动脉高压，也没有因肺栓塞的明确复发。死亡原因是恶性疾病（6例）、除肺栓塞外的心肺疾病（4例）和“猝死”（2例）。尽管未进行静脉阻断手术，长期抗凝治疗也很少见，但可能或很可能复发的栓塞发生率较低（6%）。没有明确证据表明任何患者治疗后肺动脉高压持续存在或随后发展。根据症状、体征、心电图和胸部X光检查判断，栓塞几乎总是完全消退。初始治疗后1至6个月的一些肺动脉造影显示有轻微异常，但其他在稍后时间的造影结果正常。初始治疗后1至8年进行的灌注肺扫描经常显示有轻微异常。
