急性肺动脉血栓栓塞60例临床分析

Clinical Analysis of Sixty Patients with Pulmonary Embolism

目的:为提高急性肺动脉栓塞的诊断和治疗水平,分析60例急性肺栓塞患者的临床特点及抗凝、溶栓的治疗效果。方法选择根据临床特征、超声心动图、放射性核素肺灌注/通气扫描(ECT)或电子计算机断层显像、核磁共振、选择性肺动脉造影检查确诊的60例急性肺动脉栓塞病例,分析常见病因、症状、体征及实验室检查结果,比较21例抗凝治疗及30例溶栓加抗凝治疗的治疗效果。结果:本组60例病死率为20.0%,溶栓治疗好转率为90.0%,抗凝治疗好转率57.1%。结论:急性肺栓塞是一种常见病,有较高的死亡率;放射性核素肺灌注通气扫描、肺动脉造影具有很高的诊断价值;及时诊断和治疗可显著降低病死率和病残率,溶栓治疗效果优于抗凝治疗。

Objective:To improve the levels of diagnosis and treatment of acute pulmonary embolism. This study was conducted by reviewing the clinical features as well as evaluating the effects of anticoagulation and thrombolysis on the acute pulmonary embolism patients. Method:From October 1986 to May 2006 60 patients with acute pulmonary embolism. Diagnosis was made by clinical analysis using ultrasonic cardiography, CT, MRI, radioactive nuclide lung perfusion/ventilation scan, Pulmonary arterial angiography. 30 patients were treated with combined anticoagulative and thrombolytic treatment, 21 patients anticoagulative treatment alone. Evaluation was made of their clinical diagnosis and the effects of treatment. Results:Within the subject group of 60 patients the overall mortality rate was 20.00%. The recovery rate was 90% for the combined anticoagulative and thrombolytic treatment anticoagulative treatment alone was 57.1%. Conclusion:Pulmonary embolism is a fairly common condition with a high mortality rate. Radioactive nuclide lung perfusion/ventilation scan and pulmonary arterial angiography play important roles in diagnosis of pulmonary embolism.The combined anticoagulative and thrombolytic treatment is better than anticoagulative treatment alone.