心导管术后急性肺栓塞诊治分析（附5例报告）

Pulmonary thromboembolism after cardiac catheter operation （ a report of 5 cases ）

目的探讨心内科介入治疗术后急性肺栓塞发生的危险因素、临床表现、诊治及转归情况。方法回顾性分析介入术后发生急性肺栓塞5例患者的临床资料。结果术后诊断急性肺栓塞5例，其原发病：冠状动脉粥样硬化性心脏病2例，原发性高血压2例，心律失常（阵发性室上性心动过速、阵发性心房颤动）2例，大隐静脉曲张1例。肺栓塞发生时间从介入术后24h到2d，患者在床上活动或下床活动时发生；肺栓塞主要症状是呼吸困难、胸闷、胸痛等。4例通过肺同位素通气／灌注显像确诊，1例临床诊断；4例经溶栓或抗凝治疗好转，1例死亡。结论心导管术后肺栓塞发生并非罕见，致死率高，应高度重视。

Objective To explore the manifestations,risk factors,diagnosis and treament as well as prognosis of pulmonary thromboembolism （PTE） after interventional therapy. Methods The clinical data of 5 PTE cases after cardiac catheter operation were retrospectively analzyed. Results 5 were diagnosed as PTE after operation,in whom the primary diseases were coronary atherosclerotic heart disease in 2 cases and essential hypertension in 2 cases, arrhythmias in 2 cases （ paroxysm supraventricular tachycardia and paroxysm atrial fibrillation） and saphenous vein varicosity in 1 case. The onset of PTE was from 24 hours to 2 days after the operation. The main symptoms were dyspnea and chest distress or chest pain. 4 cases were confirmed by lung ventilation/Q and 1 was clinically diagnosed. 4 cases improved after thrombolysis or anticoagulant therapy and 1 died. Conclusion Complication of PTE after cardiac catheter operation is not rare with high fetality which should be paid more attension.