构建肺栓塞诊治的“立体网络”势在必行

Construction of a comprehensive system of diagnosis and management of pulmonary embolism(Clinical analysis of 142 PE cases included)

目的探索提高肺栓塞诊治水平的有效措施。方法分析4年间本院住院的急性肺栓塞患者142例的临床诊治情况。结果构成比:60岁以上老年人较高(73%vs 27%,P<0.05);内科患者明显多于外科(79%vs 21%,P<0.05);以呼吸科(33%)、心内科(23%)为主。死亡率:外科明显高于内科(47%vs 13%,P<0.05);呼吸内科低于心内科(4.3%vs 25%,P<0.05)。结论肺栓塞为常见病,临床表现多样,涉及科室众多,单独医疗或医技科室进行诊断常造成漏诊、误诊。提高肺栓塞的诊疗水平有赖于:(1)增强诊断意识;(2)加强研究、规范治疗;(3)构建肺栓塞防治的"立体网络"。

Objective To explore effective ways of elevation in diagnosis and management of pulmonary embolism. Methods Clinical data of 142 patients with pulmonary embolism in hospital during the past 4 years were analyzed. Results Elderly people especial- ly over 60 were more likely to suffer from PE （73% vs 27% ,P 〈0. 05）. The incidence of PE in medical department was significantly higher than that in surgical department （79% vs 21%, P 〈0. 01 ）, and the patients were mainly in pneumology department （33%） and department of cardiology （23%）. The mortality in surgical department was significantly higher than that in medical department （47% vs 13%, P 〈0. 05）, and the mortality in pneumology department was significantly lower than that in department of cardiology （4. 3% vs 25%, P 〈 0. 05）. Conclusions PE is a common disease with multiplicity of clinical features, and related to numerous division. It is easily to make a misdiagnosis by single department. The following procedures are beneficial to improve PE diagnosis： （ 1 ） Enhance the awareness of PE diagnosis （2） Experiences about management of PE should be accumulated （ 3 ） A comprehensive system of management of PE should be organized.