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尿激酶和尿激酶-链激酶用于肺栓塞的试验证实,纤维蛋白溶解疗法对大面积肺动脉血栓栓塞(MPTE)有效,对阻塞肺动脉的再灌注和肺动脉压的降低均优于肝素。现评价肺动脉内应用小剂量尿激酶治疗MPTE的疗效。病例选择和方法共16例MPTE并发休克(收缩压≤10.6kPa)的患者,经血管造影确定有2个或2个以上的肺叶动脉阻塞。这些患者无心肺疾病史和明确的纤溶治疗的禁忌证。在测定血液动力学后,经肺动脉干造影确定诊断后,将导管插入阻塞的肺动脉(如果阻塞肺动脉为双侧,则置于肺动脉干)。在注射尿激酶前,先试用导管尖端破坏血凝块,所有患者初
The use of urokinase and urokinase-streptokinase for pulmonary embolism confirms that fibrinolytic therapy is effective for large-area pulmonary thromboembolism (MPTE) and is superior to heparin in blocking pulmonary artery reperfusion and pulmonary arterial pressure. The evaluation of pulmonary arterial small-dose urokinase in the treatment of MPTE. Case Selection and Methods A total of 16 patients with MPTE complicated with shock (systolic blood pressure ≤10.6 kPa) were confirmed by angiography with 2 or more pulmonary artery occlusions. These patients had no history of cardiopulmonary disease and a clear contraindication for fibrinolytic therapy. After determination of haemodynamics, the catheter is inserted into the blocked pulmonary artery (or pulmonary artery obstruction if the obstruction of the pulmonary artery is bilateral) after diagnosis of pulmonary arteriography is confirmed. Before injection of urokinase, first try catheter tip destruction of blood clots, all patients early