바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

논문 상세

이전 다음
논문 투고

Vol.59 No.6
Citation Share

만성 혈전색전성 폐고혈압 환자에서 폐동맥 혈전내막제거술의 효과

Effects of Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2005, v.59 no.6, pp.644-650
김현국 (울산대학교)
오연목 (울산대학교)
임채만 (울산대학교)
고윤석 (울산대학교)
홍상범 (울산대학교)
심태선 (울산대학교)
김우성 (울산대학교)
김동순 (울산대학교)
김원동 (울산대학교)
이상도 (울산대학교)
이재원 (한국체육대학교)
홍석찬 (울산대학교)
김현국, 오연목, 임채만, 고윤석, 홍상범, 심태선, 김우성, 김동순, 김원동, 이상도, 이재원, & 홍석찬. (2005). 만성 혈전색전성 폐고혈압 환자에서 폐동맥 혈전내막제거술의 효과. Tuberculosis & Respiratory Diseases, 59(6), 644-650.
  • 다운로드 수
  • 조회수
PDF 다운로드

초록

배 경 : 만성 혈전색전성 폐고혈압(chronic thromboembolic pulmonary hypertension, CTEPH)의 치료에 약물치료를 포함한 고식적인 방법으로는 예후를 호전시킬 수 없고 폐동맥 혈전내막제거술(pulmonary thromboendarterectomy, PTE)을 통해서 증상과 혈역학적 호전 및 생존율의 향상을 기대할 수 있다. 이에 저자들은 PTE에 의한 효과를 고식적인 치료를 받은 환자들과 비교 분석하고자 하였다.방 법 : 1995년부터 2003년까지 서울아산병원에서 CTEPH으로 진단 받은 24명의 환자를 대상으로 후향적으로 연구를 진행하였다. PTE를 시행 받았던 12명과 수술을 시행 받지 않았던 12명의 환자의 시간경과에 따른 호흡곤란 및 심초음파상 삼첨판역류 최고속도의 변화와 생존율을 비교분석 하였다.

keywords
chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy, chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy

Abstract

Background : Bilateral pulmonary thromboendarterectomy(PTE) is recognized as the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the symptomatic, hemodynamic and prognostic effects of PTE in comparison with medical treatment. Methods : Twenty‐four patients diagnosed with CTEPH from 1995 to 2003 at the Asan Medical Center were divided into two groups: patients treated with PTE(PTE group, n=12) and those not treated with PTE(Med group, n=12). The serial changes in dyspnea, the tricuspid regurgitation maximal velocity (TRVmax) and survival of the PTE and Med groups were compared retrospectively. Results : In PTE group, during a follow‐up period of 1 year, the New York Heart Association(NYHA) functional class significantly improved, while there was no significant improvement in the Med group. PTE significantly lowered the TRVmax from 4.23±0.54 m/sec to 3.22±0.70 m/sec over a follow up period of 2 years. (p=0.028) However, the TRVmax in the medically treated group did not show any significant improvement, changing from 3.98±0.68 m/sec to 4.27±0.95 m/sec during 1 year. The 5‐year survival of the PTE group was 77.9% compared with 64.3% in the medically treated group. Conclusion : PTE provides substantial long‐term improvement in dyspnea and the echocardiographic changes compared with medically treated patients. (Tuberc Respir Dis 2005; 59: 644-650)

keywords
chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy, chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy

참고문헌

1.

(1988) Pulmonary hypertension from chronic pulmonary thromboembolism,

2.

(1995) Chronic thromboembolic pulmonary hypertension, Clin Chest Med

3.

(1982) Longterm follow-up of patients with pulmonary thromboembolism:late prognosis and evolution of hemodynamic and respiratory data,

4.

(2003) Pulmonary endarterectomy: experience and lessons learned in 1,

5.

(1996) Mid-term results of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension,

6.

(1987) Surgical management of chronic pulmonary embolism:surgical treatment and perioperative problems,

7.

(1996) Chronic thromboembolic pulmonary hypertension:report of 3 case,

8.

(2001) Chronic thromboembolic pulmonary hypertension,

9.

(2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism,

10.

(2001) Prognostic factors in medically treated patients with chronic pulmonary embolism,

11.

(2003) Effect of orally active prostacyclin analogue on survival in patients with chronic thromboembolic pulmonary hypertension without major vessel obstruction,

12.

(1999) Long-term outcome after pulmonary thromboendarterectomy,

13.

(1990) Gas exchange in chronic thromboembolism after pulmonary thromboendarterectomy,

14.

(2002) Mid term effects of pulmonary thromboendarterectomy on clinical and cardiopulmonary function status,

15.

(1988) Doppler assessment of changes in right-sided cardiac hemodynamics after pulmonary thromboendarterectomy,

16.

(2000) Pulmonary endarterectomy,

17.

(2004) Chronic thromboembolic pulmonary hypertension,

18.

(2001) Pulmonary thromboendarterectomy:risk factors for early survival and hemodynamic improvement,

19.

(2000) Predictors of patient response to pulmonary thromboendarterectomy,

20.

(2004) Preoperative partitioning of pulmonary vascular resistance correlates with early outcome after thromboendarterectomy for chronic thromboembolic pulmonary hypertension,

21.

(1996) Predictors of mortality in pulmonary thromboendarterectomy,

22.

(2004) Chronic thromboembolic pulmonary hypertension,

23.

(1986) Reperfusion pulmonary edema after pulmonary artery thromboendarterectomy,

24.

(1996) Inhaled nitric oxide as an adjunct to pulmonary thromboendarterectomy,

25.

(1995) Nitric oxide improves hypoxaemia following reperfusion oedema after pulmonary thromboendarterectomy,

26.

(1999) Compassionate use of continuous prostacyclin in the management of secondary pulmonary hypertension:a case series,

Tuberculosis & Respiratory Diseases

논문 투고 OA 정책