内科卧床病人并发肺动脉栓塞的临床分析

Clinical analysis of complication pulmonary embolism on internal patients confined to bed

目的对内科卧床病人并发的肺动脉栓塞进行临床分析,探讨诊断、治疗及预防的对策。方法肺栓塞患者32例,分析一般状况、临床特点,对28例急性肺栓塞采用静脉尿激酶溶栓和肝素抗凝治疗。结果内科卧床病人急性肺栓塞发病率为28%;70岁以上为60%;其中70%有深静脉血栓,最多见的原发病为脑卒中,为60%;初诊误诊率为65.62%,总死亡率为25%;静脉溶栓有效率为85.71%。结论肺栓塞有很高的误诊率和死亡率,应对高龄的、长期卧床的并有深静脉血栓倾向的病人给予必要的预防;溶栓与抗凝疗法是治疗急性肺栓塞的有效手段之一。

Objective Through clinical analysis of complicated pulmonary embolise(PE)on internal patients confined to bed,to find out strategies for diagnosis,treatment and prophylaxis.Methods 32 cases patients of PE were selected.Analysis was made on their general conditions and clinical manifestations.For 28 acute cases of PE,the anticoagulant treatment were given respectively with heparin and intravenous injection of urokinase.Results Incident of PE on internal patients confined to bed reacted 28%.60%patients were over 70 years old.Among them 70%developed embolism in deep vein.Stroke was the most common primary disease on such patients,covering 60%. 65.62%cases were diagnosed wrong on their first visits.The totel mortality rate was 25%.The efficient of intravenous treatment to disolve embolism carne out 85.71%.Conclusion The rates of wrong diagnosis and mortality were high on patient with the PE.Measures should be tolerate for old patients who are confined to bed for a long time and who have theliability to leg embolism in deep vein.Anticoagulate treatment and treatment todissolve embolism are effective managements for acute cases of pulmonary embolism.