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혈전용해제와 체외막 산소화 장치로 치료한 광범위 폐색전증 환자 2예

Title
혈전용해제와 체외막 산소화 장치로 치료한 광범위 폐색전증 환자 2예
Other Titles
Two Cases of Treatment with Thrombolysis and an Extracorporeal Membrane Oxygenator in Patients with Pulmonary Embolism and Cardiac Arrest
Author
신정훈
Keywords
폐색전증; 체외막 산소화 장치; 혈전용해; 심폐정지; Pulmonary embolism; Extracorporeal membrane oxygenation; Thrombolytic therapy; Heart arrest
Issue Date
2015-08
Publisher
대한내과학회
Citation
대한내과학회지, v. 89, no. 2, page. 210-214
Abstract
광범위 폐색전증은 사망률이 높은 위험한 질환이다. 이러한 경우 혈전 용해제 치료를 하게 되는데 이에 반응이 없는 경우 사망률은 매우 높은 편이다. 최근에 이러한 치료에 반응이 없는 광범위 폐색전증 환자에서 ECMO를 적용하는 것이 보고되고 있다. 이에 저자들은 심폐정지를 동반한 광범위 폐색전증 환자에서 혈전 용해제 치료 후에도 심폐정지가 발생하였고 ECMO를 이용한 구조요법을 시행하여 치료한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Massive pulmonary embolism (PE) is associated with poor prognosis and high mortality. Moreover, patients with massive PE who present with shock have mortality rates ranging from 30% to 50%. Thrombolysis should be administered to patients with massive PE unless there are absolute contraindications to its use. However, treatment failure still occurs, and there is no consensus for the management of massive PE with cardiopulmonary arrest with regard to thrombolysis. In this study, two cases of massive PE with cardiopulmonary arrest are described, both of which were successfully treated with thrombolysis and hemodynamic support, which was administered by extracorporeal membrane oxygenation (ECMO). This report suggests that ECMO may provide safe and adequate cardiopulmonary support in patients with massive PE with refractory thrombolysis and cardiopulmonary arrest.
URI
http://ekjm.org/journal/view.php?doi=10.3904/kjm.2015.89.2.210http://hdl.handle.net/20.500.11754/27185
ISSN
1226-329x
DOI
10.3904/kjm.2015.89.2.210
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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혈전용해제와 체외막 산소화 장치로 치료한 광범위 폐색전증 환자 2예.pdfDownload
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