KẾT QUẢ ĐIỀU TRỊ THUYÊN TẮC PHỔI CẤP BẰNG THUỐC TIÊU SỢI HUYẾT TẠI VIỆN TIM MẠCH BỆNH VIỆN BẠCH MAI

Abstract

52 patients with acute pulmonary embolism were treated with the thrombolytic drug alteplase, median age 66, of which 17 patients received a full dose of 100 mg/2h, 35 patients received a low dose of 50 mg/2h or 0.6 mg/kg/15 minutes. Results showed that the group of patients receiving low-dose alteplase had characteristics of being older, having more respiratory failure requiring mechanical ventilation, and lower hemoglobin and hematocrit concentrations than the group receiving full-dose alteplase. The low-dose alteplase regimen showed similar efficacy to the full-dose alteplase regimen in patients with high- and intermediate-high-risk pulmonary embolism. The level of clinical improvement, hemodynamics, respiratory failure, and metabolic acidosis occurred early, immediately after using alteplase and continued to improve after 24 hours of follow-up. No patients had major bleeding during alteplase therapy and there was no difference in the rate of bleeding or the rate of severe progression at the above alteplase doses during hospital stay.