THROMBOLYSIS IN PULMONARY EMBOLISM TREATMENT-Reference-Cited by-同舟云学术

THROMBOLYSIS IN PULMONARY EMBOLISM TREATMENT

Published:2023 Issue:3 Volume:76 Page:604-609
ISSN:0043-5147
Container-title:Wiadomości Lekarskie
language:en
Short-container-title:Wiad Lek

Author:

Popovich Yaroslav M.¹,Rosul Myroslav V.¹,Sich Paula R.²,Laver Orest P.³

Affiliation:

1. STATE HIGHER EDUCATIONAL ESTABLISHMENT «UZHHOROD NATIONAL UNIVERSITY», UZHHOROD, UKRAINE; COMMUNAL NON-PROFIT ENTERPRISE «CENTRAL CLINICAL CITY HOSPITAL» OF UZHHOROD CITY COUNCIL, UZHHOROD, UKRAINE

2. COMMUNAL NON-PROFIT ENTERPRISE «CENTRAL CLINICAL CITY HOSPITAL» OF UZHHOROD CITY COUNCIL, UZHHOROD, UKRAINE

3. STATE HIGHER EDUCATIONAL ESTABLISHMENT «UZHHOROD NATIONAL UNIVERSITY», UZHHOROD, UKRAINE

Abstract

The aim: To assess the effectiveness of thrombolytic therapy in treatment pulmonary embolism. Materials and methods: The work analyzed the results of the survey and conservative treatment of 284 patients with pulmonary embolism treated in cardiological department in «Uzhgorod Central City Clinical Hospital» during 2019-2022. Patients were divided into two groups: group I – 250 (88%) patients received anticoagulant therapy; group II – 34 (12%) patients received thrombolytic therapy that was then switched to new oral anticoagulants. Results: In I group, the first three days were carried out continuously intravenous infusion of heparin in a dose of 25-30 thousand units per day, on the fourth day switched to subcutaneous injection for 10-14 days with subsequent switching to rivaroxaban. 34 (12.0%) patients of the II group, was started with thrombolytic therapy. 32 (94.1%) patients were prescribed alteplase 100 mg/day, and 2 (5.9%) patients – streptokinase 1.5 million units/day. After thrombolysis, patients were prescribed rivaroxaban for prolonged period. Thrombolytic therapy made it possible to prevent fatal cases, and in monotherapy with anticoagulants – mortality was 4.8%. Minor hemorrhagic complications like hematuria, local hematomas at the injection site, bleeding gums were observed in 7.6% of patients during thrombolytic therapy. No cases of large hemorrhages were observed. Manifestations of chronic postembolic pulmonary hypertension in the distant period were found in 97.1% and 6.9% of patients of the I and II groups, respectively. Lethality in the remote period was 5.3% – all in the 1st group of patients due to PE recurrence and acute myocardial infarction. Conclusions: Implementation of thrombolytic therapy in patients with thromboembolism of the pulmonary artery allows effectively prevent recurrence with a fatal outcome, restore the lumen of the pulmonary arteries and prevent the development of chronic postembolic pulmonary hypertension in the immediate and remote period of observation compared to isolated anticoagulant therapy.

Publisher

ALUNA

Subject

General Medicine

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