急性血栓性肺栓塞101例临床诊治体会

目的：探讨急性血栓性肺栓塞的急救流程和预后。方法回顾性分析2004-09～2013-09该院救治的急性血栓性肺栓塞101例患者的临床资料。结果101例中死亡21例,植物状态4例,痊愈76例。结论急性血栓性肺栓塞致残、致死率较高,对高危人群需要高度警惕,重在栓塞前的预防。     

肺动脉栓塞12例尸检临床病理分析

目的分析肺动脉栓塞的临床病理特征,提高临床对肺动脉栓塞(PTE)的认识水平,减少漏诊、误诊发生率。方法回顾分析我院1963年—2002年尸检证实的肺动脉栓塞12例临床及病理资料。结果12例均存在血栓性疾病的相关危险因素,基础疾病包括心脏疾病并充血性心力衰竭、肺肿瘤、创伤和手术、肺结核、肺炎、下肢静脉炎。伴发肺梗死7例。仅1例生前正确诊断。结论PTE的临床诊断困难,提高对PTE危险因素及临床规律的认识,有助于提高PTE的诊治水平,对高度怀疑者,尽早进入诊断程序。     

Massive pulmonary embolism with haemodynamic collapse

Massive pulmonary embolism with shock remains a highly fatal disease. We present twelve cases of massive embolism over the last seven years that required emergent surgery. Five patients suffered haemodynamic collapse and all died despite heroic attempts at salvage. A better outcome can only be achieved in this sub-category of patients with a rapid confirmatory diagnosis and appropriate thrombolysis and early referral to a cardiothoracic surgeon.     

Post-nephrectomy pulmonary thromboembolism

The association of pulmonary thromboembolism with nephrectomy is well documented in malignant conditions. However, the data for incidence of pulmonary thromboembolism following nephrectomy in nonmalignant conditions remains scarce. We report the first case of an incidence of pulmonary thromboembolism following nephrectomy in a patient with a nonfunctional kidney due to multiple renal calculi.     

Massive reversible pulmonary cysts in a patient with AIDS.

We report the case of a patient with AIDS who presented with bilateral, massive pulmonary cystic disease and pneumothorax presumably caused by Pneumocystis carinii which responded to treatment with cotrimoxazole. Follow-up with sequential chest X-rays and computed tomography scans showed a progressive improvement in the lung cysts which had resolved almost completely 11 months later. Several theories have been proposed to explain the cavitary lesions in this infection. The course observed in our patient suggests that a non-destructive mechanism was responsible for his lung cysts.     

Massive pulmonary hemorrhage in neonatal infection.

Of 35 newborn infants who died from an infection 19 had postmortem evidence of massive pulmonary hemorrhage. All but 1 of the 19 had evidence of antimortem formation of intravascular fibrin clots in lung tissue. Seventeen infants had low platelet counts. Of the 11 infants in whom coagulation studies were done, 8 had evidence of disseminated intravascular coagulation (DIC) during life. Vasculitis in the lungs, associated with fibrin clots and hemorrhages, was detected in two infants. It is postulated that sepsis is an important cause of hemorrhage in the newborn, probably as a result of the development of DIC.     

54例肺血栓栓塞症的临床分析

目的分析肺血栓栓塞（PTE）的危险因素、临床征象、实验室检查、治疗方法和预后。方法收集2002年1月~2010年1月在中南大学湘雅医院确诊为肺血栓栓塞症的54例住院患者的临床资料,进行回顾性分析。结果肺血栓栓塞患者中男性比女性多,下肢静脉曲张、血栓形成、手术外伤史和肿瘤史是其重要的危险因素,呼吸困难是其主要的临床表现,下肢肿痛是较常见的合并症状。结论提高对PTE的认识并及时准确诊治,对改善PTE患者的预后,延长PTE患者的生存期有很大意义。     

结核病并发肺血栓栓塞症的临床分析

目的 分析结核病并发肺栓塞患者的临床特点.方法 回顾性分析2019年1月至2020年1月于本院收治的18例结核病并发肺栓塞患者的临床-影像学资料,均给予抗结核治疗,分析一般情况、病原学结果、治疗情况、肺动脉增强CT特征、治疗及转归.结果 肺结核合并肺栓塞患者中>60岁占比66.67％,年龄可能仍为发病的高危因素;咳嗽咳...     

肺血栓栓塞症121例病因分析

目的分析肺血栓栓塞症（PTE）的病因,以提高对本病的认识,达到诊断和预防的目的。方法回顾性分析经CT增强扫描、肺动脉造影所证实的PTE患者121例,并结合文献资料进行病因学分析、探讨。结果PTE发病原因：下肢静脉曲张、深静脉血栓44例,长期卧床21例,肿瘤16例,手术13例,下肢骨折10例,肥胖8例,心脏病4例,妊娠1例,止血治疗1例,高脂血症1例,脱水治疗1例,口服避孕药史1例。结论PTE病因多种多样,病因复杂,其中以下肢深静脉血栓、肿瘤、手术史、骨折、肥胖、心脏病等较为常见,为高度危险因素。     

肺动脉栓塞42例病例分析

目的提高对肺栓塞发病机制及诊断治疗的认识。方法回顾性分析2003年6月～2006年9月肺栓塞42例临床病例资料。结果临床病例改善40例，临床病例不明显改善2例，没有死亡病例。结论肺栓塞的早期诊断至关重要，及时规范的抗凝和／或溶栓治疗可以提高治愈率。     

肺血栓栓塞症15例临床分析

目的:探讨15例肺血栓栓塞症(PTE)患者的危险因素、临床特点和治疗方案。方法:收集15例肺血栓栓塞症(PTE)患者的临床治疗,分析其临床表现、实验室检查、治疗及转归情况。结果:15例肺血栓栓塞症(PTE)患者中,突发呼吸困难和呼吸困难加重13例,晕厥3例,患者的主要临床表现为典型呼吸困难、胸痛及咯血1例,长时间制动4例,手术患者2例,口服避孕药1例。化验检查D-二聚体>500μg/L及血气分析低血氧饱和度者15例,肺动脉增强CT造影(CTPA)异常15例,溶栓治疗13例,抗凝治疗2例,症状改善不明显2例。结论:肺血栓栓塞症的发生与长期肢体制动、口服避孕药等有关,临床表现多样,典型三联症不多见,心电图及血气分析异常特异性差,肺动脉增强CT造影为确诊首选诊断方法。诊断及时及积极治疗预后良好。     

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。