肺血栓栓塞症十例临床病理分析

目的：为帮助临床进一步认识肺血栓栓塞症（PTE），对10例PTE进行临床病理分析。方法：收集近十年来的8例PTE尸检资料及2例外科肺血栓活检资料与临床进行对照分析。结果：10例PTE中，年龄3．5－72岁（平均33．3岁），来自先天性心脏病4例，心、肺恶性肿瘤各1例，风湿性心脏病1例，下肢静脉炎1例，另2例肺动脉血栓来源不明。10例中仅2例无心肺血管原发疾病，其临床PTE诊断与病理符合，余8例均未被临床诊断。结论：从本资料分析原有心血管病、心、肺肿瘤及合并肺炎（肺脓肿）患，其PTE常被临床漏、误诊。多争取病理检查，对临床医生进一步认识PTE会有帮助。

Clinical-pathological study on 10 cases of pulmonary throMboembolism

OBJECTIVE: To improve the diagnosis of pulmonary thromboembolism (PTE) by a clinical-pathological analysis of 10 cases of PTE. METHODS: Eight cases of massive and submassive (in the segmental and larger pulmonary arteries) PTE confirmed by autopsy and 2 cases of PTE who underwent surgical treatment in the past 10 years (1991 - 2001) were studied. The specimens were fixed in 10% buffered formalin, and paraffin sections cut, and stained with HE and ET + VG. The pathological features were analyzed. RESULTS: There were 8 males and 2 females, aged 3.5 to 72 years (mean 33.3). The underlining diseases included congenital heart diseases (3 cases of ventricular septal defect complicated with pulmonary hypertension, and 1 case of tetralogy of Fallot), malignant lymphoma in the heart (n = 1), rheumatic heart disease (n = 1), lung metastatic cancer from stomach (n = 1), and phlebitis of the legs (n = 1). The sources of PE remained unknown in 2 cases. Among these cases, only 2 were diagnosed clinically. CONCLUSIONS: The research showed that PTE in patients who had underlining cardiovascular diseases, malignant tumors in the heart or lungs and pneumonia (pulmonary abscess) were hard to diagnose clinically. Pathological study is helpful in improving the clinical diagnosis of PTE.