急性肺栓塞患者临床特点分析

目的回顾性分析急性肺栓塞（PTE）患者临床表现及辅助检查结果,进一步明确PTE患者临床特征。方法回顾北京军区总医院2000年1月～2011年12月间诊断急性PTE的患者143例,统计分析其临床特点,包括危险因素、临床表现体征以及实验室检查等。结果急性PTE的危险因素依次为术后卧床、脑血管病、恶性肿瘤;常见的临床表现为呼吸困难和胸闷气短;心电图多见窦性心动过速、非特异性ST-T改变、SIQIIITIII、胸前导联T波倒置;胸片多表现为肺部浸润影、右下肺动脉扩张、肺纹理稀疏等;其他常见阳性实验室结果为D-二聚体（D-dimmer）阳性占100%、低碳酸血症占90%、动脉低氧血症占88%以及白细胞升高占89%等。结论 PTE临床特征和实验室检查均无特异性,对于存在血液高凝状态的患者应警惕本病的发生。

Acute pulmonary thromboembolism: clinical analysis

Objective To analyze the clinical manifestations and results of auxiliary examinations in the patients with acute pulmonary thromboembolism （ PTE ） , and to improve the understanding to PTE by physicians. Methods The patients （ n =143 ） with acute PTE were selected from our hospital from Jan. 2000 to Des. 2011. The characteristics of patients ’ clinical manifestations were computed and analyzed. Results The risk factors of 143 patients with acute PTE were surgery, cerebrovascular diseases and cancer. The common clinical manifestations included dyspnea, oppression in the chest and shortness of breath. The common manifestations of ECG included sinus tachycardia, nonspecific ST-T changes, and T wave inversion in S I Q III , T III and precordial leads. The common manifestations of X-ray examination were lung infiltrates, dilation of right lower pulmonary artery and sparse lung markings. Other positive laboratory results included positive D-dimmer in 100% patients, hypocapnia in 90% patients, arterial hypoxemia in 88% patients and higher white blood cell counts in 89% patients. Conclusion Acute PTE is the most common risk factor for postoperative bed rest patients. The clinical manifestations of PTE have no specificities but the common ones are dyspnea, oppression in the chest and shortness of breath. The differential diagnosis should be paid special attention to.