肺栓塞37例诊断及治疗分析

Diagnosis and treatment of pulmonary embolism: a report of 37 cases

目的:探讨37例肺栓塞(PTE)患者的临床表现、诊断和治疗方案,提高PTE诊断治疗水平。方法:回顾分析37例肺栓塞病例,并对结果进行统计分析。结果:37例肺栓塞中,主要临床表现为典型的呼吸困难、胸痛及咯血"三联征"的患者仅3例;仅有胸闷症状者10例;低氧血症者占23例。二聚体>500μg/L的31例;ECT和EBT为主要诊断方法;接受溶栓治疗24例。10例行下腔静脉滤器植入术。治愈8例,好转23例,死亡4例,未治2例。结论:肺栓塞临床表现多样;X线胸片、心电图等常规检查不具特异性;二聚体增高具有筛选价值;肺通气/灌注扫描和电子束CT是首选的诊断方法;下腔静脉滤器植入可以有效预防再次肺栓塞。

Objective：To retrospectively analyze the diagnosis and treatment of pulmonary thromboembolism （PTE）. Methods：From 1999 to 2006, 37 PTE patients were admitted to our hospital, and all clinical data before and after treatment were analyzed statistically. Results： Among 37 PTE patients, 3 patients had a classical trial consisting of dyspneic respiration, chest pain and hemoptysis, 10 patients had chest pain only, and 23 patients had hypoxemia. The concentration of D - dimer exceeded 500 μg/L in 31 patients. The lung ventilation/irrigation scans （ECT） and electron beam CT （EBT） were the main diagnosis methods. Twenty -four patients received thrombolysis treatment, 8 underwent simple anticoagulant therapy, and 2 refused any treatment. Inferior vena cava filter implantation therapy was performed in 10 patients to prevent the pulmonary re -embolism. Conclusion： The clinical manifestation of PTE is atypical in most patients. Both routine chest X - ray inspection and electrocardiogram have no specificity for the diagnosis of PTE. The D - dimer detection has the screening value. The lung ventilation/irrigation scanning and electron beam CT may be the preferred diagnosis method. The inferior vena cava filter implantation may prevent the pulmonary re -embolism.