外科手术后肺栓塞18例临床分析

目的分析外科手术后患者急性肺栓塞的临床特点。方法回顾我院2000年—2006年期间外科手术后肺栓塞患者18例的一般资料、临床特点及实验室检查、治疗经过。结果平均发病年龄52.5岁,15例出现氧分压下降,呼吸困难是急性肺栓塞最常见的临床症状,8例并发下肢深静脉血栓形成,只有3例出现心电图的典型改变(SⅠ,QⅢ,TⅢ),16例D-二聚体检查阳性(有鉴别诊断价值)。加强CT及肺灌注扫描是安全、可行的检查项目,具有诊断价值。结论外科手术后并发下肢深静脉血栓是急性肺动脉栓塞的主要危险因素,积极的溶栓治疗可显著改善预后,临床医师应引起高度重视。

Clinical Analysis of Characteristics of 18 Cases with Postoperative Pulmonary Embolism

Objective To analysis the clinical characterstics of postoperative pulmonary embolism (PE) in order that more attention will be paid to its prevention. Methods Cinical data were gathered from the patients with postoperative PE hospitalized at No.254 hospital during the year of 2000 to 2006. Retrospective analysis was performed on the aspects of general materials, clinical manifestation, laboratory test and therapy.Results Their average age was 52.5 years old. There were 15 cases whose PaO_2 descended. Dyspnea was the most common clinical symptom of PE. There were only three cases with electrocardiogram changes in the waves of S_Ⅰ, Q_Ⅲ and T_Ⅲ, and 16 patients with a ascension of D-dimer which was helpful to the differentiation from other diseases. The enhanced pattern of CT scan and radionuclidic infusion were safe and reliable way to the diagnosis. Conclusion Deep venous thrombosis of lower limb after surgical operation is an important factor for acute PE and clinical doctor should pay more attention to it. Anticoagulant therapy should be administered.