肺栓塞相关因素与预后关系的临床分析

Clinical analysis of the relationship with various risk factors of pulmonary embolism and their prognosis

目的提高对肺栓塞(PE)危险因素与预后关系的认识。方法对149例PE病例做回顾性分析。结果PE的主要临床表现为吸困难(83.2%)为最常见的症状,其次为胸痛(49.7%),咳嗽(26.2%),咯血(20.1%),晕厥(14.8%),心悸(14.1%),低血压(13.4%),PE最常见的危险因素依次为:血栓性静脉炎(33.6%)、心脏病(19.5%)、外伤(14.1%)、手术(8.1%)、恶性肿瘤(7.4%),且随年龄的增长,危险因素的数量也增多。149例PE患者,溶栓治疗48例,总有效率为77.1%,与抗凝组疗效比较差异有显著性(P<0.01)。结论认识PE的各种危险因素,及早给予预防和治疗是降低PE发生率和病死率的关键。

[Objective] To have a better understanding of the relationship with various risk factors of pulmonary embolism(PE)and their prognosis.[Methods] Review of clinical data of 149 cases with PE treated in the first affiliated hospital of China Medical University from 1990~2002.[Result] The most common clinical presentation of PE were dyspnea(83.2%),chest pain(49.7%),cough(26.2%),hemoptysis(20.1%),faint(14.8%),cardapalmus(14.1%),and hypotension(13.4%).The most common risk factors of PE were deep venous thrombosis(33.6%),heart disease(19.5%),trauma(14.1%),surgery(8.1%),malignancy(7.4%).The number of risk factors increased with increase of age.149 patients with PE were treated with different regimens.Of the 48 patients treated with thrombolytic therapy,77.1% showed improvement in lung perfusion scan,lung CT,arteial blood gas and clinical presentation,the percentage was significantly higher than that of the anticoagulant group(P <0.01).[Conclusion] It is essential to identify various risk factors of PE and to select suitable prevention and treatment as early as possible.It will decrease the incidence and the mortality of PE.