介入溶栓治疗胸腔镜下肺癌根治术后高危肺栓塞的经验分析

Experience analysis of interventional thrombolytic therapy for high-risk pulmonary embolism after thoracoscopic radical lung cancer surgery

摘要:

目的 探讨不同介入溶栓方式治疗胸腔镜下肺癌根治术后高危肺栓塞（PE）的价值。方法 选取2018年就诊于河南大学第一附属医院的3例胸腔镜下肺癌根治术后发生高危PE的患者作为研究对象，其中1例接受单纯静脉溶栓治疗，1例接受单纯动脉介入溶栓治疗，1例接受静脉肺动脉联合介入溶栓治疗，分析3例患者住院治疗方式、溶栓治疗效果和术后并发症发生概率。结果 接受单纯静脉溶栓治疗、单纯动脉介入溶栓治疗和静脉肺动脉联合介入溶栓治疗的患者，溶栓后住院时间分别为32、22和11 d，介入溶栓治疗的临床效果较传统静脉溶栓治疗好，3例患者出院后均进行6个月的随访，无明显并发症出现。结论 因肺癌行胸腔镜根治术后发生高危PE的患者，采用肺动脉介入溶栓方式能够明显提高临床治疗效果，缩短患者住院时间，值得临床推广应用。

Abstract:

Objective To compare the different interventional thrombolytic methods of high-risk pulmonary embolism after thoracoscopic radical lung cancer surgery, and analyze the experience of the treatment process, so as provide reference for thoracic surgeons in diagnosis of such diseases.Methods Three patients with high-risk thrombolysis after thoracoscopic radical resection of lung cancer in 2018 were selected as the research subjects, of which 1 patient accept simple intravenous thrombolysis treatment, 1 case of patient with simple arterial interventional thrombolysis treatment, 1 case of patient with pulmonary venous infusion interventional thrombolysis therapy, the hospitalization method, thrombolytic treatment effect and postoperative complication probability of 3 patients were analyzed.Results The length of stay after thrombolysis was 32 d, 22 d and 11 d in patient received simple intravenous thrombolysis therapy, simple arterial interventional thrombolytic therapy and combined venous and pulmonary artery interventional thrombolytic therapy, respectively. The clinical effect of interventional thrombolytic therapy is better than traditional intravenous thrombolytic therapy. All the 3 patients were followed up for 6 months after discharge, and no significant complications occurred.Conclusion For patients with high risk pulmonary embolism after thoracoscopic radical resection of lung cancer, pulmonary artery interventional thrombolysis can significantly improve the clinical treatment effect and shorten the length of hospital stay of patients, which is worthy of clinical promotion and application.