肺栓塞106例临床分析

A clinical analysis of 106 cases of pulmonary embolism

目的分析肺栓塞(pulmonary embolism,PE)的临床特点和诊疗方法,提高诊治水平。方法回顾性分析106例住院治疗的PE病例的临床特点、诊断和治疗方法以及效果。结果PE患者近年增加明显,存在易患因素,以下肢静脉深静脉血栓形成为最常见的因素。其症状和体征是非特异性的,最常见临床表现为呼吸困难;螺旋CT、放射性核素肺通气/灌注显像、肺动脉造影等均有助于诊断。溶栓治疗12例,存活10例;介入治疗11例,存活9例;单纯抗凝治疗83例,存活74例。结论提高对PE的认识,对及时准确诊断PE具有重要意义;螺旋CT、放射性核素肺通气/灌注显像、肺动脉造影是诊断PE的有效方法。恰当的治疗策略对改善预后具有积极意义。

Objective To improve diagnosis and treatment of pulmonary embolism （PE） through analyzing the clinical features and modalities of its diagnosis and therapy. Methods The clinical data of 106 PE cases treated in Tongji Hospital were reviewed. Results With more and more cases having been diagnosed in recent years, PE patients were recognized that it was associated with a number of risks including venous thrombosis, the most frequent risk factor. The clinical symptoms and signs of PE were usually nonspecific, as 90.6% cases showing common symptom of dyspnea. To diagnose PE, physicians could use various examinations including ventilation/perfusion scan, pulmonary angiography, and helical computerized tomography of thorax. Of the 106 cases with PE, 12 received thrombolytic therapy, l0 survived and 2 died; 11 received catheter-based thrombus fragmentation in combination with local fibrinolysis, 9 survived and 2 died; 83 received anticoagulant therapy, 74 survived and 9 died. Conclusion Medical professionals should improve the recognition of clinical features, which is important to get earlier and precise diagnosis and decrease the mortality and misdiagnosis. These measures, including ventilation/perfusion scan, helical computerized tomography of thorax, pulmonary angiography, are the effective ways to diagnose this disease. Suitable treatment strategy is positive to improve the prognosis.