急性肺血栓栓塞症住院患者危险度分层与发病因素的相关性分析

Correlation Analysis of Risk Factors in Different Risk Inpatients with Acute Pulmonary Thromboembolism

目的:研究急性肺血栓栓塞症(APTE)住院患者危险度分层与发病因素间的相关性,为早期识别高危患者,指导临床诊治提供依据。方法:回顾性分析内蒙古自治区人民医院2003年1月～2012年12月诊断为APTE的143例患者的临床资料,根据《急性肺血栓栓塞症诊断治疗中国专家共识》中APTE危险度分级标准,分为中、高危组和低危组,对两组资料进行统计分析。结果:2003～2012年我院APTE院内发病率从0.19‰上升至0.58‰;病死率从33.3%下降至10.5%。APTE患者最常见的临床症状为呼吸困难、胸痛、发热和咳嗽;最常见的体征为呼吸增快、体温升高、心率增快及发绀。年龄、合并心脏病及脑血管疾病与危险度分组具有相关性。其中年龄越大,有脑血管病及心脏病的患者,发生中高危APTE的风险越高。结论:近10年内蒙古自治区人民医院APTE院内发病率呈明显上升趋势,病死率呈下降趋势。高龄、合并心脏病和脑血管疾病者发生中高危APTE的风险升高。

Objective：This paper analyzes risk factors in different risk inpatientswith APTE,in order to provide the basis for the early identification of high-risk patients and guiding clinical diagnosis and treatment.Methods：Retrospectively analyzes the clinical data of 143 patients who were diagnosed as APTE from January 2003 to December 2013 in Inner Mongolia People＇s Hospital.They are classified as medium-high-risk and low-risk groups according to the risk classification standards in Expert Consensus of APTE Diagnosis and Treatment in China.Two groups of APTE patients are statistically analyzed in the correlation between different risk classifications and the risk factors.Results ：In Inner Mongolia People＇s Hospital,the APTE nosocomial morbidity rises from 0.19 ‰ to 0.58 ‰ from 2003 to 2012;fatality rate falls from 33.3% to 10.5%.The most common clinical symptoms of APTE patients are dyspnea,chest pain,fever and cough.The most common signs of APTE patients are faster breathing,fever,increasing heart beat and cyanosis.Age,merger of heart disease or cerebrovascular disease are associated with risk classifications.The more medium and high risks will occur if patients with heart disease or cerebrovascular disease are at a higher age.Conclusions：APTE nosocomial morbidity in Inner Mongolia People＇s Hospital has obviously shown a rising trend in recent 10 years,while fatality rate has been on the decline.Increasing medium and high risk of APTE is found among the elderly people with heart disease or cerebrovascular disease.