基层医院急性肺血栓栓塞症诊治分析

Diagnosis and treatment of acute pulmonary embolism in primary care hospital

目的：了解基层医院急性肺血栓栓塞症（APE）的诊断治疗情况。方法回顾性分析17例急性肺动脉血栓栓塞症（APE ）患者的临床资料，根据其临床症状、实验室检查、影像学方面检查等指标进行Geneva和Wells评分并进行危险分层，同时记录治疗情况及预后。结果在此期间共诊断APE患者17例，其中男10例，女7例，平均年龄（51．8±18．4）岁（23～81岁）；Geneva评分≤3分4例，4～10分9例，≥11分4例；Wells评分≤4分6例；＞4分11例；低风险2例，中度风险15例；平均住院时间（10．9±5．4）d。17例中死亡1例，好转7例，显效7例，治愈2例。14例行抗凝治疗，3例无抗凝治疗，11例行溶栓治疗，开胸手术1例，2例置入下腔静脉滤器，6例行造影和碎栓加抽吸术。结论对APE的警惕性越来越高，但对其治疗与随访管理还有待进一步规范。

Objective To get the knowledge of the diagnosis and treatment of acute pulmonary embolism （APE）in primary hospital.Methods The clinical data of the patients diagnosed with APE were retrospectively reviewed.The patients were clarified into different risk-group by revised Geneva score and Wells score according to the clinical records.Results 17 patients were diagnosed with APE in this time slot,in which male 10 cases and female 7 cases,average age was （51.8 ±18.4）years old,and among them,4 cases with 4 scores of revised Geneva score,9 cases with 4 to 10 scores,4 cases with more than 11,6 cases with less than 4 Wells score,11 cases with more than 4,2 cases with low risk and 15 cases with intermediate risk.The length of hospital stay was （10.9 ±5.4）days in average.In this group,one patient was dead,seven cases improved,six cases remarkably improved and three cases were recued.Fourteen patients received anticoagulation agents and three cases without any.Eleven patients were given thrombolystic therapy,one case was operated and six cases were given interventional treatment.Conclusion Clinicians know APE and keep alert gradually.However,it should be improved in respects of treating and following the APE patients.