肺血栓栓塞症44例临床分析

目的了解肺血栓栓塞症(PTE)的临床特点并提高诊断、治疗水平。方法回顾性分析44例PTE的临床表现及胸部影像学、肺通气灌注显像、下肢深静脉核素造影、下肢深静脉和心脏彩色多普勒超声检查、心电图和动脉血气分析的特点。结果深静脉血栓形成是导致PTE最主要的危险因素。慢性心肺疾息、风湿性疾病、糖尿病、外科手术、创伤、骨折和恶性肿瘤等也是其主要危险因素。本组患者无一例死亡。结论PTE仍极易被临床忽视、漏诊和误诊。应密切关注其临床特点、辅助检查结果并进行综合分析,以及时、准确地诊断及治疗。

Clinical analysis of 44 cases with pulmonary thromboembolism

Objective To promote early diagnosis and treatment of pulmonary thromboembolism (PTE) by familiarizing the clinical features. Methods A retrospective analysis of 44 cases of PTE was performed with respective to the clinical characteristics, chest imaging CT pulmonary angiography (CTPA) , ventilation and perfusion (V/Q) imaging, colored Doppler ultrasound of deep veins and the heart, ECG and arterial blood gas analysis. Results Deep vein thrombosis (DVT) was the most important risk factor of PTE, other risk factors included chronic cardiopulmonary disease, malignant tumors, diabetes mellitus, rheumatic disease, trauma, surgical operations and fracture of bone. Conclusions PTE is a rather common disease and is still often ignored in clinical practice with high rates of misdiagnosis. Attention should be paid to be familiar with the clinical features and diagnostic imaging findings for obtaining correct diagnosis and prompt treatment. (Shanghai Med J, 2006, 29:715-717)