MEDICAL COMPARED WITH SURGICAL-TREATMENT FOR MASSIVE PULMONARY-EMBOLISM

被引：136

作者：

GULBA, DC

SCHMID, C

BORST, HG

LICHTLEN, P

DIETZ, R

LUFT, FC

机构：

[1] UNIV HANNOVER,DEPT MED,DIV CARDIOL,W-3000 HANNOVER,GERMANY

[2] UNIV HANNOVER,DEPT THORAC & VASC SURG,W-3000 HANNOVER,GERMANY

[3] FREE UNIV BERLIN,W-1000 BERLIN,GERMANY

来源：

LANCET | 1994年 / 343卷 / 8897期

关键词：

D O I：

10.1016/S0140-6736(94)91523-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We compared embolectomy (when available) with thrombolysis in patients with shock and massive pulmonary embolism. 13 patients were operated on, 10 (77%) of whom survived. The inferior vena cava was routinely clipped. The 24 medically treated patients were given alteplase until systemic and pulmonary artery pressures stabilised and heparin thereafter; 16 (67%) survived. Major haemorrhage occurred in 28% of medically treated patients, but was not fatal. 1 patient had a small cerebral haemorrhage that resolved without drainage. One-fifth of the medical group had a re-embolism, which suggests that temporary caval umbrellas are indicated in medically treated patients. Thrombolysis may provide a life-saving option and a randomised trial is warranted.

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收藏

页码：576 / 577

页数：2

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