下肢创伤并发肺栓塞溶栓效果的^(99m)Tc-MAA肺灌注显像观察

The Thromobolytic Therapeutic Evalution in Lower Extremital Posttraumatosis and Postoperation Patients with Pulmonary Thromoboembolism by ^(99m)Tc-MAA Pulmonary Perfusion Imaging

目的:利用99mTc-大颗粒聚合白蛋白(MAA)肺灌注显像(PPI)观察下肢创伤及手术后(LEPP)并发肺栓塞(PE)患者的溶栓疗效。方法:19例临床确诊的LEPP并发PE患者分别于溶栓治疗前、治疗2~4周后进行PPI;PPI图像上显示一个肺段灌注完全缺损记3分,缺损25%~75%记2分,<25%记1分,无异常记0分,根据记分变化分析溶栓治疗前后临床改善情况。结果:19例患者溶栓治疗2~4周后临床症状完全消失10例,明显改善6例,有改善3例。治疗前(10.2±3.8)、后(2.8±1.4)PPI记分差异有显著性(P<0.01)。结论:PPI为一种准确、可靠的无创性评价肺血流改善的手段,对LEPP合并PE患者疗效观察具有可靠的临床价值。

Objective：To investigate the role of pulmonary perfusion imaging（PPI） in evaluating the thromobolytic therapy in lower extremital posttraumatosis and postoperation patients （LEPP） with pulmonary thromoboembolism （PE）. Methods： 19 LEPP with PE （3-28 days disease course） underwent PPI before thrombolysis and after 2-4 weeks＇ treatment. The lung segments with 100 % lack of perfusion was marked 3,those denmonstated 25 % - 75 % marked 2,〈 25% marked 1 and normal marked 0. The therapeutic results were compared with the marks＇ changes. Results：The clinical symptoms of 10 cases were fully disappear after 2-4 weeks＇ treatment, 6 significant improved, 3 improved. The marks were significant difference between before（10.2±3. 8） and after（2.8±1.4） treatment（t= 7.75,P〈0.01）. Conclusion：PPI is an effective and noninvasive method for evaluating changes of lung blood flow,it could play an important role on evaluating therapeutic efficiency in LEPP with PE patients.