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-  2016 

致死性肺栓塞导致心脏骤停两例并文献复习

DOI: doi:10.7507/1671-6205.2016039

Keywords: 致死性肺栓塞, 心脏骤停, 溶栓, 自主循环恢复

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Abstract:

目的 通过对致死性肺栓塞(FPE)导致心脏骤停患者的临床特点的描述,结合系统文献回顾,总结FPE的救治要点,提高FPE的诊治水平。 方法 回顾分析2例FPE导致心脏骤停患者的救治过程。在Medline(1950~2014年)和EMbase(1980~2014年)两个文献检索系统中检索关于应用溶栓剂治疗FPE导致心脏骤停的文献,对FPE的治疗加以系统总结。 结果 2例患者均为外科手术后发生FPE,经心肺复苏、溶栓及抗凝治疗好转,但其中1例患者在抗凝期间发生大出血。共检索到6篇关于FPE导致心脏骤停的文献,共分析72 473例患者,主要为肺栓塞所致心脏骤停或血流动力学不稳定的高危肺栓塞患者,溶栓药物为重组组织型纤溶酶原激活物或链激酶,各研究中给药的方式和剂量均不相同。总体来讲,溶栓治疗可以缩短患者自主循环恢复的时间,提高患者的生存率,但是出血风险有所增加。 结论 FPE导致心脏骤停有很高的病死率,临床医生必须及时甄别。早期应用溶栓治疗非常重要,可以改善患者预后

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