研究探讨心血管超声诊断在肺动脉栓塞诊断中的临床应用

Study of Clinical Application in the Diagnosis of Pulmonary Embolism in Ultrasonic Diagnosis of Cardiovascular

目的探讨研究心血管超声诊断在肺动脉栓塞诊断中的应用价值,为肺动脉栓塞的临床诊断提供切实依据。方法随机选取2009年6月—2014年12月来该院经CT、心电图、肺灌注扫描及通气显影等方法确诊的肺动脉栓塞的患者60例,同时对其行无创心血管超声检查,并对所做超声检查的结果进行分析。结果有3例患者检测到肺动脉栓塞的直接征象,其中有2例左肺动脉栓塞的患者,表现为部分阻塞,另有1例在患者为右心房栓塞,栓子在右心房侧壁上附着;有45例患者存在肺栓塞的间接征象,具有室间隔向左侧移位、右心房及右心室出现扩大、右室/左室的比值增大等表现;另外有36例患者存在三尖瓣返流的情况。通过心血管超声检查诊断为肺动脉栓塞的患者共48例,对肺栓塞的诊断率为80.0%,另外12例患者未能通过心血管超声检查及时作出肺栓塞的诊断,其漏诊率为20.0%。结论对患者行心血管超声检查,能够对肺动脉栓塞的患者或疑似患者的诊断提供一定的依据,并且具有无创、方便、快捷及成本低等优点,值得在临床上推广应用。

Objective To study the cardiovascular ultrasound diagnosis value in the diagnosis of pulmonary embolism,provides the practical basis for the clinical diagnosis of pulmonary embolism.Methods 60 cases whom electrocardiogram（ecg）,pulmonary perfusion CT scan and ventilation imaging methods such as diagnosis of pulmonary embolism in our hospital from June 2009 to December 2009 were randomly selected,at the same time taking uneffective noninvasive cardiovascular ultrasound examination,and analysis the results of ultrasound results.Results There were 3cases detected the direct signs of pulmonary embolism,including 2cases of patients with left pulmonary embolism,characterized by partial obstruction,and 1 case for right atrium in patients with embolization,embolus in the right atrial wall adhesion;45 cases of pulmonary embolism in patients with indirect signs,with ventricular septal shift to the left and right atrium and right ventricle appear to expand,the ratio of right/left ventricular enlargement;In addition there are 36 patients with tricuspid regurgitation.By cardiovascular ultrasound in the diagnosis of pulmonary embolism in patients with a total of 48 cases,for the diagnosis of pulmonary embolism（80.0%）,the other 12 patients failed the cardiovascular ultrasound examination in a timely manner to make the diagnosis of pulmonary embolism,the missed diagnosis rate was 20.0%.Conclusion For patients with cardiovascular ultrasound to the diagnosis of pulmonary embolism patients or suspected patients to provide a certain basis,and a noninvasive,convenient,efficient and low cost advantages,is worth popularization and application in clinic.