208例肺栓塞的临床分析

Clinical Analysis of 208 Cases of Pulmonary Embolism

目的回顾性分析肺栓塞病例的临床特点、诊断和治疗方法,减少漏诊、误诊,提高对肺栓塞患者的诊断率和治愈率。方法对2009年1月至2013年9月入住山西省人民医院的208例肺栓塞患者的相关危险因素、临床表现、辅助检查结果及治疗方法进行回顾性分析。结果 1肺栓塞患者临床表现多样,主要有呼吸困难、咳嗽、胸憋、胸痛和下肢肿胀。2肺栓塞的主要相关危险因素依次为深静脉血栓形成、高血压、吸烟和心功能不全。3常规检查项目中D-二聚体测定可作为筛查肺栓塞的敏感但非特异性指标。4溶栓序贯抗凝治疗与单纯抗凝治疗的治愈率比较二者差异有统计学意义,总有效率差异无统计学意义。结论肺栓塞临床表现及常规检查缺乏特异性,对疑诊患者应综合考虑,提高确诊率,积极治疗。

Objective To retrospectively analyze the clinical features,diagnosis and therapy of pulmonary embolism for reduction of misdiagnosis and missed diagnosis, and for improving the cure rate. Methods The data of related risk factors, clinical manifestation, auxiliary examination results and treatment of 208 patients with pulmonary embolism in Shanxi Province people＇s hospital were summarized. Results 1Pulmonary embolism in patients with clinical manifestations of diversity, mainly include dyspnea, cough, chest suppress, chest pain and swelling of lower limbs. 2The main risk factors related to pulmonary embolism are deep vein thrombosis, high blood pressure, smoking and cardiac insufficiency. 3Routine inspection project D-dimer determination can be used as screening sensitive but not specific indicator of pulmonary embolism. 4Thrombolysis sequential anticoagulation compared with pure anticoagulant therapy cure rate was statistically significant difference in, there was no statistically significant difference in total effective rate. Conclusions clinical manifestation of pulmonary embolism and routine inspection lack of specificity, and should be considered in patients with suspected diagnosis, increase the rate of diagnosis, treat actively.