肺血栓栓塞症治疗前后临床与CT对比研究

The comparative study of clinical and CT performance pulmonary embolism before and after treatment

目的通过对比肺血栓栓塞症(PTE)治疗前后临床表现及CT肺动脉血管造影(CTPA)检查表现的变化,探讨溶栓和抗凝治疗的疗效,以及在PTE治疗过程中复查CTPA的临床价值。方法收集36例确诊PTE患者的完整临床资料及CTPA影像资料,进行回顾性分析。结果本组患者治愈24例(66.67%),好转9例(25.00%),总有效率为91.67%,死亡3例(8.33%)。溶栓或抗凝治疗1周、2周、1个月、3个月栓子个数进行性减少,两两之间差异均具有统计学意义(P均<0.01);溶栓或抗凝治疗6个月后栓子个数进一步减少,但与治疗3个月相比差异无统计学意义(P均>0.05)。结论早期诊断并积极溶栓、抗凝治疗疗效好,CTPA是PTE诊断和疗效评价的有效影像学检查方法,对PTE的治疗具有指导作用。

Objective To study the clinical significance of thrombolysis, and anticoagulant therapy for pulmonary thromboembolism （PTE） through comparing clinical and CT performance before and after treatment, and evaluate the value of computed tomographic pulmonary angiography （CTPA） rechecking in treatment. Methods The clinical and CTPA data of 36 PTE patients were retrospectively analyzed. Results Twenty-four patients with PTE were cured（66.67% ） ,9 cases were improved （25.00%） and 3 cases were died（ 8.33% ）. At the time points of one day, two weeks, one month and three months after thrombolysis therapy,the embolus numbers in PTE patients continued to decrease, and there was statistical difference between each two time points （P 〈0.01 ）. The embolus numbers further decreased 6 months after treatment, but the differ- ences had no statistical significance compared with the 3rd month （ all P 〉 0.05 ）. Conclusion Early active thrombolytic and anticoagulant therapy has a better therapeutic effect for PTE. CTPA is an effective imaging examination for diagnosis and therapeutic evaluation of pulmonary embolism, and it also has a guiding effect for the treatment of pulmonary embolism.