广西地区1995—2007年13家综合医院肺血栓栓塞症调查

Incidence and clinical outcomes of pulmonary embolism in 13 general hospitals in Guangxi area from 1995 to 2007

目的了解广西壮族自治区综合医院肺血栓栓塞症(PTE)诊治状况。方法选择广西地区13家地市级综合医院1995—2007年住院PTE病例为调查对象,由呼吸科医生阅读所有PTE病历。比较1995—2001年和2002—2007年PTE病例占同期住院病例的比例、诊断方法以及病死率。结果1995—2007年广西13家综合医院共诊断PTE460例,占总住院病例的1.9%,2002—2007年PTE占住院病例比例(3.0%,419/1378752)较1995—2001年(0.4%,41/1053769)显著增加,后6年确诊病例比例(55.13%,231/419)显著高于前7年(14.63%,6/41)。PTE医院内病死率为29.78%,后6年病死率(28.16%,118/419)显著低于前7年(46.34%,19/41)。结论广西地区PTE诊断率和病死率仍不乐观,需要进一步提高临床医生对PTE的认识以及优化PTE诊断方法。

Objective The incidence and outcome of pulmonary embolism（PE） vary among general hospitals around the world. The incidence and clinical outcomes of PE in the last decade are not clear in Guangxi Zhuang Autonomous Region, a province in the south China. This study attempts to investigate the current status of PE in the general hospitals of Guangxi. Methods Thirteen general hospitals in Guangxi were recruited. Hospital records of PE cases from 1995 to 2007 were retrieved from databases and studied by pulmonalists. The rate of PE to total inpatients, diagnostic techniques and mortality of PE in these hospitals were compared in different periods. Results There were 460 patients with PE in 2 432 521 inpatients（ 1.9% ）in the 13 general hospitals from 1995 to 2007. The incidence of PE （3.0%） during 2002--2007 was significantly higher than that of 1995--2001 （0. 4% ）. Most diagnosis of PE （ 85. 37% ） based on clinical characteristics and laboratory test during the first seven years. The definite PE accounted for 14. 63% and 55. 13% of PE cases from 1995 to 2001 and 2002 to 2007 respectively （ P 〈 0. 01 ）. Overall inhospital mortality of PE was 29.78%. The last 6 years saw a significant decrease of mortality compared with the first 7 years （28. 16% vs 46. 34% ）. Conclusion There is room for considerable improvement in the management of pulmonary embolism in Guangxi area. Enhancement of PE knowledge and optimizing the approach to diagnosis of PE should be the focus.