以晕厥就诊的肺血栓栓塞患者临床特点分析

目的:研究以晕厥就诊肺血栓栓塞患者的临床特点,希望能对提高肺血栓栓塞患者的生存率提供帮助。方法:收治晕厥患者351例,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。按照晕厥发生原因,将非PE组分为反射性晕厥组(R组)、心源性晕厥组(C组)、脑源性晕厥组(B组)及其他晕厥组(O组)。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、凝血相关指标的差别。结果:晕厥患者中,7.7%的患者为PTE所至晕厥;各组性别构成、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组既往单下肢肿胀、气短、咯血、腓肠肌压痛的发生率高于其他各组;PTE组胸闷、双下肢肿胀的发生率高于R组、B组和O组,但与C组无显著性差异;PTE组PT、APTT、TT较其他各组明显延长,FIB、DD及FDP较其他各组明显升高。结论:以晕厥就诊的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,凝血检查多有异常。

Objective：To explore the clinical characters of pulmonary thromboembolism（PTE） with syncope as the first symptom.Method：351 patients were divided into the group of PTE and the group of no PTE.According to the etiology of syncope,the group of no PTE was divided into reflectivity syncope（group R）,cardiogenic syncope（group C）,encephalic syncope（group B） and other syncope（group O）.Compared the difference of gender,age,past history,other associated symptoms,signs,PT,APTT,TT,FIB,DD and FDP between PTE and no PTE.Result：The gender and age in each group had no significant difference.The patients with three or more risk factors for venous thrombosis 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 other groups.The incidence of both lower extremities edema、dyspnea in PTE group was significantly higher than group R,B and O,but there was no significant difference between PTE group and group C.The PT、APTT and TT in PTE group were significantly longer than other groups.The DD、FIB and FDP in PTE group were significantly higher than other groups.Conclusion：The patients of PTE with syncope as the first symptom have more 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.