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大面积肺血栓栓塞症 (PTE)应予溶栓治疗 ,但若合并存在右心内血栓则属溶栓的相对禁忌证。本例在溶栓后再度发生严重呼吸困难 ,应考虑为血栓自右心房或同时从下肢深静脉内脱落所致又一次肺血栓栓塞。此类病例的治疗存在诸多棘手之处 ,需加慎重考虑 ,必要时需请本领域内外科专家会诊 ,以决定一个相对周全的处理方案。
Large pulmonary thromboembolism (PTE) should be thrombolytic therapy, but if combined with right ventricular thrombosis is the relative contraindication of thrombolytic. This case of re-occurrence of severe respiration after thrombosis, should be considered as thrombus from the right atrium or both from the lower extremity deep vein thrombosis caused by another pulmonary thromboembolism. The treatment of such cases there are many difficult points, need to be carefully considered, if necessary, need to consult the surgical experts in the field to determine a relatively comprehensive treatment options.