Chest:静脉内植入性曲前列尼尔治疗肺动脉高压

2017-06-20 xiangting MedSci原创

曲前列尼尔的全植入设备的手术是成功的,并发症少。

前列腺素可以改善肺动脉高压(PAH)的症状和生存率。为了应对外部输液系统带来的风险,开发了一种植入式的静脉输注设备。这是一项多中心前瞻性单臂临床试验(DellVery for PAH),用来评估使用该设备曲前列尼尔治疗PAH。该研究重点描述了与植入程序相关的发现。

入选接受静脉曲前列尼尔的PAH(WHO组1)患者(n = 64)。手术前患者转为使用临时外周静脉输液导管。在10个中心由不同专业的医生在全身麻醉或深静脉镇静下进行设备植入。中央静脉通路是通过头、锁骨下、颈静脉或腋静脉。使用导引器和荧光镜引导,将输液导管的远端放置在上腔静脉-右心房交界处。将导管从静脉通路位置通道穿入放置泵的腹部皮下袋中。

在64例入选患者中,4例在植入前出院。60例植入手术都是成功的。基线时,所有患者通过外部泵以71.4±27.8 ng/kg/min(范围为22至142 ng/kg/ min)的平均剂量接受曲前列尼尔。植入手术时间平均为102±32分钟(范围47至184分钟)。临床上主要的植入手术相关并发症包括1例气胸、2例感染和1例房颤。2例患者中出现3次导管植入后错位。常见的植入相关事件而不是并发症包括植入部位疼痛(83%)和瘀伤(17%)。

曲前列尼尔的全植入设备的手术是成功的,并发症少。

原始出处:

Aaron B. Waxman,et al. Totally Implantable Intravenous Treprostinil Therapy in Pulmonary Hypertension: Assessment of the Implantation Procedure. Chest. June 2017.

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    2017-10-15 Smile2680
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    2017-07-24 fusion
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    2017-06-22 jiyangfei
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    2017-06-20 三生有幸9135

    学习一下谢谢分享

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肺动脉高压(PH)较为罕见,但它是使用酪胺酸激酶抑制剂(TKIs),如达沙替尼治疗患者的一种致命的不良事件,且未在使用伊马替尼或尼罗替尼的患者中进行过全面评价。2017年5月,发表在《Br J Haematol》的一项研究调查了使用伊马替尼、尼罗替尼、达沙替尼治疗患者的肺动脉高压的发生情况。

CIRC RES:儿童肺动脉高压新分型!

儿童肺动脉高压(PH)是一种异质性的病理现象,自然病程和对治疗的反应都不尽相同。因此,对其进行一个精确的分型对于个体化治疗来说尤为关键。近日,在国际心血管权威杂志《Circulation research》上发表了一篇通过仔细研究儿童PH的临床表现来评估应用基于网络的从纵向数据库中记录的并发症数据进行疾病分型的可行性的大型临床研究。

Haematologica:脾切除术后心血管事件和肺动脉高压的风险如何?

总之,脾脏切除患者的卒中发生风险增加。此外,潜在的脾切除术相关疾病解释了脾切除术后心肌梗死、肺动脉高压风险增加的原因。