23例肺血栓栓塞症临床特征分析

Analysis of the Early Clinical Characteristics in 23 Patients with Pulmonary Thromboembolism

目的:探讨肺血栓栓塞症(PTE)早期临床特征、早期诊断手段,提高对急性PTE的诊断率。方法:回顾性分析2000年1月至2005年8月本院23例急性PTE患者的临床特征、辅助检查结果等资料。结果:呼吸困难(65%)、胸痛(36%)、晕厥(26%)、咯血(13%)等为急性肺血栓栓塞症最典型的早期表现。动脉血气分析、心电图、血浆D-二聚体、肺核素检查、核磁共振成像(MRI)检查为重要的诊断手段。结论:急性肺血栓栓塞症早期可无特异性临床表现,但对排除了其它原因的呼吸困难、胸痛等表现后,特别是血气分析有明显低氧血症而临床无法解释时应高度重视,应及早进行肺血栓栓塞症的相关检查,提高早期确诊率,以防误诊和漏诊。

Objective： To explore the early clinical characteristics and early diagnosis tools in patients with pulmonary thromboembelism and to increase the diagnosis rate in the emergency. Methods： The early clinical characteristics and the results of investigation were reviewed retrospectively from Jan 2000 to Aug 2005. Results： The typical early clinical presentations included dyspnea （65%）, chest pain （36%）, syncope26%） and haemoptysis （13%）. Arterial gas analysis, electrocardiagram（ECG）, serous D-dimer and chest nuclear magnetic resonance（MRI） were important diagnosis tools. The early diagnosis rate is 35%. Conclusion： The early clinical features of the acute pulmonary thromboembelism were non-specific. More attention should be paid to dyspnea and chest pain, in particulary with hypoxemia, and associated investigaions should be timly made in order to increase the diagnosis rate.