Kết quả điều trị huyết khối động mạch phổi bằng tiêu sợi huyết đường tĩnh mạch tại Bệnh viện Trung ương Quân đội 108

Abstract

Pulmonary embolism (PE) is a severe and life-threatening condition caused by thrombotic obstruction of the pulmonary artery branches, often originating from the veins of the lower limbs or pelvis. It is one of the leading causes of cardiovascular mortality, following myocardial infarction and stroke. Fibrinolytic therapy with rtPA has proven to play a critical role in saving patients' lives. However, at the Heart Institute, 108 Military Central Hospital, there has been no comprehensive evaluation of the treatment outcomes, prompting the need for this study to summarize clinical experiences. Objective: To evaluate treatment outcomes of intravenous thrombolytic therapy for pulmonary embolism at 108 Military Central Hospital. Subject and method: This cross-sectional study was conducted on 22 patients with acute pulmonary embolism due to thrombosis at the 108 Heart Institute from January 2019 to November 2024. Clinical and paraclinical parameters, as well as complications, were assessed before and after fibrinolytic therapy. Result: Patients treated with rtPA (Alteplase), clinical and paraclinical parameters, such as heart rate, blood pressure, SpO₂, and pulmonary artery pressure, showed significant improvement. However, bleeding complications were observed in some patients with risk factors, including recent surgery or late-stage malignancy. Conclusion: Fibrinolytic therapy with rtPA effectively improves clinical and paraclinical outcomes in patients with high-risk acute pulmonary embolism. Nevertheless, caution is required due to the risk of bleeding complications.