急性肺栓塞血气及CTPA诊断分析

Analysis of artery blood gas and CTPA data of acute pulmonary embolism

目的:分析急性肺栓塞(APE)患者基础疾病、实验室及CTPA检查资料,探讨低氧分压及栓子栓塞肺动脉分支差异的机制。方法:分析APE患者基础疾病、血气及CTPA检查资料,观察肺叶及肺段各动脉分支栓子部位、数量。1 5例正常人作为对照组。采用x^2检验对各分支动脉栓塞率比较;对照组与APE组比较用两组独立样本t检验;以P<0.05为差异有统计学意义。结果:APE组各项血气分析PaO_2、PaCO_2及SaO_2均较对照组减低(P<0.05);本组APE患者,栓子共累及240处肺动脉,右肺动脉153条(栓塞率24.0%),左肺动脉87条(栓塞率17.8%)。右肺上叶动脉累及31条(栓塞率15.8%),右肺中叶动脉累及27条(栓塞率8.4%),右肺下叶动脉累及95条(栓塞率32.3%);左肺上叶动脉累及肺动脉23条(栓塞率15.6%),左肺下叶动脉累及64条(栓塞率18.6%)。结论:临床疑诊APE患者,要重视实验室及CTPA检查,并合理进行应用。

Objective： To analyze the clinic, laboratory and CTPA data of pulmonary embolism, and to investigate its mechanism. Methods： Underlying diseases, CTPA data, and artery blood gas analysis of forty-nine consecutive patients diagnosed as PE were studied. The location and number of emboli were analyzed and recorded. Fifteen patients without PE were recruited in the control group. Results： The values of PaO2, PaCO2, SaO2 were significantly lower （ P〈0.05） in the patients of APE than those in the control group. Two hundred and forty segment and lobe arteries involved by emboti were found in all patients. There were 31 arteries involved by emboli in the right upper lobe in all the patients（15.8 % ）, 27 in the middle lobe of right lung （8.4%）, 95 in the lower lobe of right lung （32.3%）, 23 in the upper lobe of left lung（15.6%）, 64 in the lower lobe of left lung（18.6 % ）. Conclusion： To suspected APE patients, laboratory and CTPA examination should be thought highly of and car- ried out reasonably.