X线平片、CT平扫及CT肺血管造影诊断肺栓塞的临床分析

Clinical analysis of X-ray plain film, CT scan and CT pulmonary angiography in the diagnosis of pulmonary embolism

目的:分析和探讨对肺栓塞患者采用X线平片、CT平扫及CT肺血管造影诊断的临床价值,以期为肺栓塞患者的临床诊断方法的选择提供借鉴。方法:2011年1月-2014年1月收治肺栓塞患者87例,回顾性分析其临床资料,所有患者均采用X线平片、CT平扫及CT肺血管造影技术进行诊断,比较3种方法的临床检出率。结果:X线平片26例表现出轻度异常,检出率29.89%,主要表现为少量胸腔积液、肺浸润影、心脏增大、肺不张、肺动脉高压等;CT平扫51例表现出异常,检出率58.62%,可见右心影增大、肺体积的减小、腔静脉增粗、肺动脉高压等;CT肺血管造影87例表现出异常,检出率100.00%,主要表现为栓塞远端肺动脉变细、栓塞肺动脉的充盈缺损、侧支循环形成、肺血流的低灌注及不均匀灌注、心影增大以及近心端肺动脉高压。差异均有统计学意义(P<0.05)。结论:采用CT肺血管造影诊断肺栓塞的检出率最高,该方法能显著提高患者临床诊断的准确性,能够为患者疾病的临床治疗提供可靠的依据,因此值得临床推广使用。

Objective:To analyze and explore the clinical value of using X-ray plain film,CT scan and CT pulmonary angiography in the diagnosis of patients with pulmonary embolism,in order to provide reference for patients with pulmonary embolism to choose clinical diagnosis method.Methods:87 patients with pulmonary embolism were selected from January 2011 to January 2014.The clinical data were retrospectively analyzed.All patients were given X-ray plain film,CT scan and CT pulmonary angiography for diagnosis.The detection rates of 3 methods were compared.Results:26 cases showed mild abnormalities in X-ray plain film;the detection rate was 29.89%;their major performance were a small amount of pleural effusion,pulmonary infiltrates,heart enlargement,pulmonary atelectasis,pulmonary artery hypertension and so on.51 cases showed abnormalities in CT scan;the detection rate was 58.62%;their major performance were right heart shadow increase,lung volume reduction,vena cava enlargement,pulmonary hypertension and so on.87 cases showed abnormalities in CT pulmonary angiography;the detection rate was 100.00%;their major performance were distal embolization thin pulmonary artery,embolism pulmonary artery filling defect,the formation of collateral circulation,pulmonary blood flow low perfusion and non-uniform perfusion,increased heart shadow and proximal pulmonary arterial hypertension.The differences were statistically significant(P<0.05).Conclusion:Using CT pulmonary angiography in the diagnosis of pulmonary embolism has the highest detection rate.This method can significantly improve the accuracy of clinical diagnosis of patients, and it can provide reliable basis for the disease clinical treatment of patients,so it is worth wide use in the clinical.