急性脑血管病后合并肺栓塞8例临床诊治分析

Analysis of Diagnosis and Treatment of 8 Cases With Acute Cerebrovascular Disease Complicated With Pulmonary Embolism

目的:总结急性脑血管病后合并肺栓塞的临床特点,诊治现状,提高对疾病的诊治水平和生存率。方法:对8例急性脑血管病后合并肺栓塞患者的易患因素、临床表现、辅助检查、治疗及转归进行临床分析。结果:8例患者中,急性脑梗死6例,急性脑出血2例,易患因素主要为长期卧床,高龄,肥胖,充血性心力衰竭,吸烟;临床表现不典型,主要为呼吸困难,咳嗽,不明原因烦躁,心悸,咳血;治疗方面仅2例给予抗凝治疗并且症状好转,4例未予抗凝治疗,症状无好转且其中2例出院1月内死亡,2例年轻患者发病1h内死亡。结论:急性脑血管病后合并肺栓塞易患因素多,临床症状不典型,早期诊断和治疗难度大,预后差,临床医师应充分重视提高早期诊断水平,以提高生存率。

Objective：To summarize the clinical manifestations,diagnosis and treatment of acute cerebrovascular disease complicated with pulmonary embolism in order to improve the level of diagnosis and treatment of the disease and the survival rate.Methods：The risk factors,clinical manifestations,accessory examination results,treatments and the outcomes were analyzed in 8 patients with acute cerebrovascular disease complicated with pulmonary embolism.Results：Of 8 cases,6 were cerebral infarction and 2 were cerebral hemorrhage.The main risk factors included bedridden,senile,obesity,congestive heart failure and smoking.Clinical manifestations were atypical,mainly including dyspnea,cough,restlessness,palpitation and hemoptysis.Only 2 cases received anticoagulation therapy and the symptoms were improved;the symptoms did not improved in 4 cases without anticoagulation therapy,2 cases died within a month after discharged from hospital and 2 young patients died within an hour after the onset of the disease.Conclusions：Acute cerebrovascular disease complicated with pulmonary embolism has many risk factors,and the clinical manifestations are atypical.As early diagnosis and treatment is difficult,prognosis is poor,clinician should promote the level of early diagnosis in order to improve the survival rate.