The involvement of lung thrombus thromboembolism treats _'s treatment

The involvement of lung thrombus thromboembolism treats _'s treatment
Involvement treatment of the acute lung thrombus thromboembolism
Lung thrombus thromboembolism of acute large area (AMPTE) Case fatality rate up to 30%, among them 2/3 die 1 hour after having illness coming on, accurate treatment intervene, can make case fatality rate it drops to 8% to be following in time. Once AMPTE patient makes a definite diagnosis of, should pay immediately anticoagulatorily and treat, thereupon offering dissolves the bolt treatment. Have, dissolve bolt taboo AMPTE of card many surgery fetch the intersection of bolt and treatment in the past, but surgery risk great, and patients who dissolves the bolt taboo card avoid the card for the operation more, has already seldom adopted now, only used for dissolving the bolt, getting involved in the patient who jeopardizes the life who treated the taboo card or failed to respond to any medical treatment.
Through the garrulous bolt of conduit and except that the bolt can relieve the lung artery thromboembolism of centre rapidly, reduce the lung arterial pressure, correct the unstable state of dynamics of blood flow, save the patient's life. Get involved in the maturity of technology with the blood vessel, getting involved and treating AMPTE in recent years is paid attention to day by day.
1. The garrulous bolt of conduit and except that the bolt treats AMPTE
1.1 Mechanism: It is more than 4 times of the centre lung artery to carry arteriolar total horizontal sectional area of the lung far, the capacity of the peripheral lung blood vessel bed is more than 2 times of the centre lung artery. Getting involved can suck the embolus out of or turn the fragment into and make it enter to carry the lung artery to treat far, thus open the centre lung artery and reduce the artery resistance of lung rapidly, obviously increase the total lung blood flow, improve blood dynamics state and right room function of the heart and lungs.
1.2 Adapt to the card: First of all, patient accord with diagnostic standard of AMPTE, and thromboembolism position lie in, get involved apparatus but and position (general apparatus can use sections of centre lung artery of the above for) ,Accord with one of the following standards at the same time: Anticoagulatory or dissolve the bolt taboo card; Internal medicine department dissolved the bolt or positive fails to respond to any medical treatment; Cause pulmonary embolism of fatal character: Mean the heartbeat gathers stopping, shock, fainting, going into a coma, hypotension of progressive whole body, or serious dyspnea, cyanosis and hypoxemia disease patient difficult to correct appearing rapidly; Patient who has heart and lungs disease previously at advanced age; Holding the chest operation, holding the chest operation taboo card, postoperative hair or unwilling operation person again unconditionally. Generally speaking, the garrulous bolt of conduit and except that the bolt is effective to the new blood bolt within 3 weeks, more than pieces of curative effect are bad or invalid in 3 weeks.
1.3 Daily apparatus
(1) Smoke and absorb the bolt conduit (Embolectomy Device) in negative pressure : Use the big syringe through inserting in the direct negative pressure of conduit in the position of artery thrombus of lung and smoking and sucking, suck out of the new blood bolt. Common type: Smoke and absorb the bolt conduit, Lang negative pressure to smoke and absorb the bolt conduit in Greenfield negative pressure.
(2) Spray the brine garrulous bolt at a high speed and except that the bolt conduit: This kind of conduit is each at least, terminal small curves a ring-type, open and meet at an angle of 180 degrees with terminal conduit. Terminal big has large side holes. High speed high-pressure brine spray in direction opposite to conduit, phenomenon and vortex on the gentle mound produce in loud of split from childhood, cause the thrombus to break and be inletted into great, then with dashing into the big brine of to discharge outside the body at a high speed. Common type: Hydrolyser except that bolt conduit, Oasis except that bolt conduit, AngioJet, except bolt
Conduit,etc..
(3) Rotate pig's tail conduit: It is the improved high torque 5F pig's tail conduit, pig's tail ring regards leading silks as the pivot and rotates and produces garrulous bolt function. The near end of the conduit can also connect a low-speed electrical machinery and drive the conduit to rotate the garrulous bolt. Because RPC is easy to use, cheap, the garrulous bolt result is reliable, are still used on clinic at present.
(4) Garrulous bolt sacculus conduit: Insert with the intersection of lung and the intersection of artery and position of embolus garrulous the intersection of bolt and the intersection of sacculus and sacculus of conduit, inflate and push the broken embolus. This law is only effective to fresh embolus.
(5) Rotate the garrulous bolt conduit of network basket: Garrulous bolt through the network basket rotated at a low speed in thrombus position in the lung artery directly, or is protecting the conduit (or network basket) The high-speed network basket rotated produces the vortex near the thrombus, produce garrulous bolt function and utilize the effect in the gentle mound to draw the thrombus to the further garrulous bolt of network basket inside. Common type: Garrulous bolt device of Arrow-Trerotola network basket, rotating the garrulous bolt conduit of one pair of baskets.
(6) Rotate the garrulous bolt device of the turbine: The conduit terminal high-speed turbine rotated causes the vortex in the lung artery near the thrombus, produce garrulous bolt function and utilize the effect in the gentle mound to draw the thrombus to the further garrulous bolt of turbine. Has not protected outside the early high-speed turbine rotated, it is apt to damage the blood vessel wall. Have drum or network basket that is protected, avoid damaging the blood vessel wall and playing garrulous bolt two times role more outside the high-speed turbine rotated now. Rotate turbine garrulous the intersection of bolt and conduit to can break to pieces the thrombus micron size particle, its power comes from the direct current machine or pneumatic turbine. Common type: Kensey garrulous bolt device, Amplatz turbine garrulous bolt device, garrulous bolt device of network basket of turbine.
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