非下肢深静脉血栓导致肺栓塞20例临床分析

目的分析非下肢深静脉血栓(DVT)所致肺栓塞病例,增强对非下肢DVT来源肺栓塞的认识,提高肺栓塞患者的救治率。方法回顾性分析2018年1月至2021年12月在本院行肺动脉CTA确诊的肺栓塞47例的病例资料,根据是否存在下肢DVT分为下肢DVT组(27例)和无下肢DVT组(20例),比较两组入院至确诊PE时间、SpO2、D二聚体、肌钙蛋白、心脏彩超表现及转归。结果两组SpO2、D二聚体、肌钙蛋白、心脏彩超差异无统计学意义(P>0.05),无下肢DVT组入院至确诊PE时间更长,死亡率更高(P<0.05)。结论非下肢深静脉血栓来源肺栓塞临床上存在延误诊断及死亡率高情况,建议一线临床医师应高度重视。

Objective To study the pulmonary embolism caused by non-lower extremity deep vein thrombosis(DVT),improve the understanding of non-DVT pulmonary embolism,and improve the success rate of pulmonary embolism patients.Methods The data of 47 cases of pulmonary embolism confirmed by pulmonary artery Computed Tomography Angiography(CTA)were retrospectively analyzed in Affiliated Hospital of Jiaxing University from January 2018 to December 2021.According to the existence of DVT,27 cases were divided into the lower extremity DVT group and 20 cases were divided into the non-lower extremity DVT group.Their clinical manifestations were compared,including time from admission to diagnosis of PE,SpO2,D-dimer,troponin I,and cardiac color Doppler ultrasound data between the two groups.Results There was no significant difference between the two groups in SpO2,D-dimer,troponin I,and cardiac color Doppler ultrasound(P>0.05).The time from admission to diagnosis of PE was longer,mortality rate of the non-lower extremity DVT group was higher,with statistical significance(P<0.05).Conclusion Non-lower extremity thrombosis pulmonary embolism has a high rate of delayed diagnosis and mortality,which should be taken seriously by first-line clinicians.