肺栓塞临床分析

Clinical analysis of lung embofism cases

目的提高对肺栓塞的认识和诊治水平。方法对23例肺栓塞患者的超声检查、X线影像学检查、肺通气／血流灌注检查等资料进行回顾性分析。结果23例肺栓塞患者都有下肢深静脉炎或血栓形成、术后、创伤或不适当的长期卧床、慢性心肺疾病、糖尿病和肿瘤等基础疾病。由于及时诊断和及时的抗凝治疗，17例（73．9％）患者治疗后存活。23例肺栓塞患者采用放射性核素肺通气／灌注扫描，阳性率为95％。结论肺栓塞仍是一个被人们认识不足的疾病，因此应予重视，并要求我们对临床高度怀疑者应尽快进行肺栓塞的诊断程序。放射性核素肺通气／关注扫描是一项安全、简便、无创、有价值的肺栓塞的筛选和诊断方法。

Objectives To discuss the diagnosis and therapy of lung embolism. Methods Twenty-three cases of lung embolism were reviewed with uhrasonography, X ray, radionuclide V/Q imaging of lung and other clinical examinations. Results Twenty-three cases of lung embolism was found in patients who suffered from deep low- er limb venous inflamations or blood embolization, and also in postoperative or trauma or long time in-bed patients. Chronic cardiac and respiratory disease, diabetes and cancer were often the causes of lung embolism. 17 of 23 cases （73.9%） survived because of accurate diagnosis and timely anticoagnlation treatment. In order to make accurate diagnosis, venous uhrasonography, chest X-ray, chest CT, plasma D-dimer examinations and electrocardiogram were usually used. Radionuclidc V/Q imagin of lung with an effhive rate of 95% was proved to be a safe, simple, non-invasive examination. Conclusions Lung embolism is not well known by most clinic physicians. An accurate diagnosis can be made with timely clinic examinations.