广西地区13家综合医院肺栓塞诊断技术分析

目的 了解各种肺栓塞(PE)诊断技术在诊断PE中的应用.方法 对广西地区13家三级甲等综合医院1995年至2007年PE病例的诊断方法进行回顾性调查分析.根据临床表现以及普通检查诊断的PE病例为临床诊断病例,根据特殊影像检查结果或尸体解剖诊断的病例为确诊病例.比较各种PE诊断方法在诊断为PE患者中的比例以及不同年份各种诊断方法所占比例.结果 1995年至2007年13家医院诊断为PE患者460例,其中确诊病例237例(占51.52%),临床诊断病例223例(占48.48%).2002年至2007年确诊病例占同期PE病例的55.13%,较1995年至2001年14.63%明显提高(X~2=24.522,P<0.01).237例确诊病例中,17例由2项检查确诊,由肺动脉造影、CT肺动脉造影、超声检查、磁共振成像以及尸体解剖各诊断27例(11.39%)、214例(90.30%)、6例(2.53%)、5例(2.11%)和2例(0.84%),没有肺通气灌注显像确诊病例.2003年以后采用CT肺动脉造影广西地区确诊PE所占比例升高.其他检查技术则略有下降.结论 CT肺动脉造影是广西地区诊断PE的首选方法,其他诊断技术的临床应用有待加强.

A retrospective survey of diagnostic techniques of pulmonary embolism in 13 general hospitals in Guangxi area

Objective To survey different diagnostic techniques in diagnosing pulmonary embolism (PE).Methods Hospital records of PE cases in 13 AAA general hospitals in Guangxi area from 1995 to 2007 were studied retrospectively.Probable PE was defined as the diagnosis based on the clinical data and non-specific imaging,while the definite PE was defined as those with the diagnosis confirmed by specific imaging or autopsy.The percentage of various diagnostic methods of PE was analyzed.Results From 1995 to 2007,237 definite PE and 223 probable PE were found in 13 hospitals,and they accounted for 51.52 % and 48.48%,respectively,for all patients diagnosed as having PE.The percentage of definite PE cases during 1995-2001 and 2002-2007 were 14.63% and 55.13%,respectively(X~2=24.522,P＜0.01).Among 237 definite PE,2 positive diagnostic techniques were employed in 17 patients.Twenty-seven(11.39%),214(90.30%),6(2.53%),5(2.11%)and 2(0.84%)patients were diagnosed by pulmonary angiography,CT pulmonary angiography(CTPA),ultrasonography,magnetic resonance imaging(MRI)and autopsy,respectively.No ventilation-perfusion lung scanning was performed in these patients.Compared with other diagnostic imaging,the percentage of CTPA in diagnosis of PE increased slightly since 2003.Conclusion CTPA is the first choice in the diagnosis of PE in Guangxi area,and more attention should be paid to other diagnostic imaging techniques.