急性肺血栓栓塞症的腔内溶栓治疗:病例报告和文献综述

Germán Londoño-Ruíz , Diego Tibavizco
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引用次数: 0

摘要

肺血栓栓塞症是心肺骤停的常见病因,是一种需要特殊治疗的疾病,即使在临床高度怀疑但未确诊的病例中也应进行治疗。溶栓治疗在不同的结果中都显示出良好的效果。本文介绍了一名因下肢溃疡感染而住院的 72 岁糖尿病、高血压和甲状腺机能亢进患者,该患者出现呼吸困难,随后出现呼吸衰竭、休克和心肺骤停,根据超声波征象诊断为肺血栓栓塞,并在休克状态下进行了溶栓治疗,从而恢复了自主循环,休克也逐渐缓解。本文回顾了有关心肺复苏术中溶栓的文献,得出结论认为,在肺血栓栓塞症中,控制临床风险至关重要,因为高风险患者的死亡率较高,必须采取再灌注措施。在高度怀疑肺血栓栓塞的心肺骤停患者中,超声波对诊断有重要价值,产中溶栓可提高自发循环恢复率甚至存活率。
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Trombólisis intraparo en tromboembolismo pulmonar agudo: reporte de caso y revisión de la literatura

Pulmonary thromboembolism is a frequent cause of cardiorespiratory arrest, this being an entity with specific treatment, which should be established even in cases with high clinical suspicion without confirmed diagnosis. Thrombolysis has shown good results in different outcomes. A 72-year-old diabetic, hypertensive, hyperthyroid patient is presented, hospitalized for an infected lower limb ulcer, who presented respiratory distress with subsequent ventilatory failure, shock and cardiorespiratory arrest, who was diagnosed with pulmonary thromboembolism due to ultrasound signs and was intra-arrest thrombolysis was performed, thereby achieving return to spontaneous circulation and gradual resolution of the shock. A review of the literature on intra-arrest thrombolysis is carried out, concluding that in pulmonary thromboembolism managing clinical risk is of vital importance, since those at high risk have higher mortality rates and the establishment of reperfusion measures are essential. In cardiorespiratory arrest with high suspicion of pulmonary thromboembolism, ultrasound is valuable to support the diagnosis and intrapartum thrombolysis has a higher rate of return to spontaneous circulation and even survival.

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