肺通气／灌注显像对急性肺血栓栓塞症的诊断及疗效评价

Diagnosis and Curative Effect of the Lung Ventilation/Perfusion Scintigraphy for Acute Pulmonary Thromboembolism

目的评价放射性核素肺通气／灌注显像对急性肺栓塞的诊断价值及溶栓效果的价值。方法对65例临床确诊或高度怀疑急性肺栓塞、病程在2周以内的患者,进行肺通气／灌注显像检查,对具备溶栓指征者实行静脉溶栓治疗,对所有诊断为肺栓塞的患者均进行抗凝治疗,于治疗后15-30d复查肺灌注显像。结果在65例患者中,高度可能性肺栓塞患者45例,中度可能性患者12例,低度可能性患者8例。对30例具备溶栓指征且无溶栓禁忌证的患者进行了溶栓治疗。随诊肺灌注显像显示51例患者的肺灌注有改善,其中高度可能性肺栓塞患者41例,中度可能性患者9例,低度可能性患者1例,另14例无变化。结论肺通气／灌注显像是诊断急性肺栓塞判断治疗效果的一种无创、安全、可靠、可重复的检查方法,可作为急性肺栓塞患者常规的检查手段。

Objective To evaluate the application value of the Lung Ventilation/Perfusion Scintigraphy for the diagnosis and curative effects in patients with acute pulmonary thromboembolism. Methods Lung Ventilation/Perfusion Scintigraphy was performed in 65 patients with known or suspected pulmonary thromboembolism within two weeks after the onset of symptoms. Follow - up study was performed in those patients who received thrombolytic therapy and/or anti - coagulation. Results High, medium and low probability for pulmonary thromboembolism on Lung Ventilation/Perfusion Scintigraphy was present in 45, 12 and 8 patients respectively. Follow - up study showed improved pulmonary perfusion in 51 patients, 41 patients of which with high probability, 9 with medium probability and only 1 with low probability. Pulmonary perfusion was unchanged in 14 patients. Conclusion Lung Ventilation/Perfusion Scintigraphy is a noninvasive, accurate technique for the diagnosis and assessment of therapeutic efficacy in patients with pulmonary thromboembolism.