肺栓塞诊断治疗的临床分析

Clinical analysis on the diagnosis and treatment of pulmonary embolism

目的：评价肺栓塞的诊断方法及治疗措施。方法：对2003年1月～2005年5月人院并确诊的29例肺栓塞的诊断、治疗方法进行分析。结果：29例肺栓塞患者中，低氧血症79．3％，D-二聚体〉500μg／L 84．2％，心脏超声典型改变的51．9％，增强螺旋CT和肺动脉造影敏感性为95．8％和100％。接受溶栓治疗的14例中无一例死亡，接受抗凝治疗15例中死亡1例。结论：肺栓塞的发病与易患因素密切相关，肺栓塞的临床症状体征不典型，需结合辅助检查进行诊断。溶栓治疗可提高患者生存率。

Objective：To evaluate diagnostic strategy and clinical management for patients with pulmonary embolism. Method：The predisposing factors, diagnosis and treatment of 29 consecutive patients with established pul monary embolism were analyzed retrospectively. Result：In all 29 patients with pulmonary embolism, 79.3% had hypoxemia, 84.2% had D-Dimer 〉500μg/L, 51.9% had typical findings on ultrasonic cardiogram. The sensitivity of CT and pulmonary angiography were 95.8% and 100%. 14 patients received thrombolytic therapy, none died. The other 15 patients received anticoagulant therapy, one died. Conclusion：The incidence of pulmonary embolism is closely related to the associated factors. Clinical symptoms and signs of pulmonary embolism were atypical. The role of clinical assessment was important. Thrombolytic treatment can improve the survival rate of patients with pulmonary embolism.