床旁胸片检查结合血浆D-二聚体测定对肺栓塞的诊断价值

目的：探讨床旁胸片检查结合血浆 D-二聚体（D-dimer,DD）测定肺动脉栓塞（pulmonary embolism,PE）的应用价值。方法：对16例临床可疑PE患者进行床旁胸片检查结合血浆DD测定，以临床诊断为依据，分别评价床旁胸片、DD测定以及床旁胸片检查结合血浆DD测定对PE诊断价值。结果：床旁胸片Westermark征6例（37.5%），肺动脉高压6例（37.5%）（其中2种表现交叉者3例），肺炎样改变2例（12.5%），胸腔积液2例（12.5%），3例（18.75%）未见明显异常X线征象；DD测定全部阳性（16例），阳性率100%。结论：床旁胸片检查结合血浆D-二聚体测定是对PE较为准确而又迅速的诊断方法，并对疗效判定有重要价值。

The Value of Bedside Chest X-ray and Plasma D-dimer Determination in the Diagnosis of Pulmonary Embolism

Objective：To explore diagnostic value of bedside chest X-ray and plasma D-dimer （DD） determi-nation in the diagnosis of pulmonary embolism （PE）. Methods：All 16 patients received bedside chest X-ray and plasma DD determination, taking clinical diagnosis as the evidence, the values of bedside chest X-ray, DD determi-nation, the combination of both in the diagnosis of PE were respectively assessed as well as clinical effects in the treatment for thrombosis. Results：There were six cases of Westermark signs showed in bedside chest X-ray （37.5%）, six cases of pulmonary artery hypertension （PAH） （37.5%） （There were three cases manifesting both of the signs）, two cases with pneumonia-like changes （12.5%）, two cases of pleural effusion （12.5%） and three cases without the appearance of obvious abnormal X-ray signs （18.75%）;the results of DD determination were all positive （16 cases）, positive rate 100%. Conclusion：Bedside chest X-ray and plasma DD determination are accurate and rapid diagnostic methods for pulmonary embolism, which shows important values in the assessment of clinical effects.