以胸痛就诊的肺血栓栓塞患者临床特点分析

Clinical characters of pulmonary thromboembolism with chest pain as first symptom

目的研究以胸痛就诊肺血栓栓塞(PTE)患者临床特点,希望对降低肺血栓栓塞患者的死亡率提供帮助。方法选取南阳市中心医院院2008年1月—2009年12月就诊的晕厥患者856例作为观察对象,按照核素肺通气灌注显像检查结果将观察对象分为PTE组和非PTE组。按照胸痛发生原因,将非PE组患者分为心血管性胸痛、肺源性胸痛、胃肠源性胸痛、骨骼肌肉源性胸痛、带状疱疹性胸痛。分析PTE患者与非PTE患者性别、年龄、既往病史、其他伴随症状、体征的差别。结果胸痛患者中,10.2%的患者为PTE所至晕厥;各组患者性别构成、年龄均无显著性差异,PTE组具有3个以上静脉血栓危险因素的患者明显高于其他组;PTE组患者既往单下肢肿胀、气短、咯血、下肢腓肠肌压痛的发生率高于其他各组。结论以胸痛就诊的PTE患者常合并有多个静脉血栓的危险因素,其既往下肢肿胀的发生率高,常合并气短、咯血及腓肠肌挤压痛阳性。

Objective To explore the clinical characters of pulmonary thromboembolism（PTE）with chest pain as the first symptom.Methods Totally 856 patients were divided into the group of PTE and the group of no PTE.According to the etiology of chest pain,the group of no PTE was divided into cadiovascular group,lung-derived group,gastrointestinal-derived group,muscle-derived group and herpes zoster group.Compared the difference of gender,age,past history,other associated symptoms and signs in different groups.Results The gender and age in each group had no significant difference.The patients with three or more risk factors for venous thrombosis in PTE group were significantly higher than other groups.The incidence of single lower extremity edema,short breath,hemoptysis,gastrocnemius muscle extrusion pain in PTE group was significantly higher than that of other groups.Conclusions The patients of PTE with chenst pain as the first symptom have more risk factors for venous thrombosis the patients with syncope.The incidence of lower extremity edema and coagulopathy are higher.The incidence of short breath,hemoptysis,gastrocnemius muscle extrusion pain in PTE group was significantly higher in patients of PTE with syncope as the first symptom.