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فوزیه فرجی، مهدی برازش، مجید دژبخت

In patients with acute pulmonary embolism, thrombolytic results in a more rapid resolution of pulmonary emboli than Heparin treatment and improved hemodynamic are clear. Whether this advantage results in an improved clinical outcome is unclear. We performed a 5-year retrospective clinical study and compared thrombolytic and nonthrombolytic treatment in patients with massive pulmonary thromboembolism (PTE). .Also in this investigation, we studied PTE incidence in Shahid Rajaee heart center, mortality rate in two groups, relationship between massive PTE with sex and age. From 80431 patients that admitted in Shahid Rajaee Heart Center in 5 years, the incidence of PTE was 41cases in 10000 patients and massive PTE was 15 in 10000 patients .There were no relationship between age and sex with massive PTE. (P Value= 0.737 and 0.408). In comparison of hemodynamic changes in before, 24 and 48 hr after treatment in thrombolytic group, there were normal reduction in PR (P Value <0.001), SPAP (P Value = 0.034) and in TRG ( P Value = 0.030) and in non-thrombolytic group, we found no special changes in hemodynamic factors. Also we performed comparison between before and 24hr and before and 48hr after treatment in each groups and we observed reduction in SPAP (P Value = 0.022), TRG (P Value = 0.044) and RVD (P Value = 0.042) in before and 24hr after treatment with thrombolytic. And in before and 48hr after treatment in this group, there were reduction in DBP (P Value = 0.027), PR (P Value <0.001), TRG (P Value = 0.005) and RVD (P Value = 0.006). Also, in before and 24hr after in nonthrombolytic group, there were reduction in SBP (P Value = 0.032), DBP (P Value = 0.003), PR (P Value = 0.004) and in before and 48hr comparison in this group, we observed changes in SBP (P Value 0.005), DBP (P Value = 0.002), PR (P Value <0.001) and RVE (P Value = 0.043). In this study, we had 14 case deaths in thrombolytic group and 14 deaths in other group. In the base of this study, we found that there are no relationship between age and sex and massive PTE incidence. There is more effect in thrombolytic treatment vs. non-thrombolytic treatment in more rapid improvement hemo-dynamically but it isn’t effective in decrease of mortality in massive PTE patients. Treatment

Keywords: Massive Pulmonary Embolism, Non-Thrombolytic Treatment, Thrombolytic Treatment

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فرجی، فوزیه، برازش، مهدی، دژبخت، مجید، 1400، مقایسه پیامد بالینی بیماران آمبولی حجیم ریه ، در دو گروه درمان ترومبولیتیک و درمان غیر ترومبولیتیک ، از سال 2006 تا 2011 در مرکز قلب شهید رجایی، سیزدهمین کنگره قلب و عروق خاورمیانه و ششمین همایش مداخلات پیچیده قلبی، http://conf.sums.ac.ir/fa/archive_index.php?c=HN-mecc13&aid=1512540