23例肺血栓栓塞症临床特征分析

目的:探讨肺血栓栓塞症(PTE)早期临床特征、早期诊断手段,提高对急性PTE的诊断率。方法:回顾性分析2000年1月至2005年8月本院23例急性PTE患者的临床特征、辅助检查结果等资料。结果:呼吸困难(65%)、胸痛(36%)、晕厥(26%)、咯血(13%)等为急性肺血栓栓塞症最典型的早期表现。动脉血气分析、心电图、血浆D-二聚体、肺核素检查、核磁共振成像(MRI)检查为重要的诊断手段。结论:急性肺血栓栓塞症早期可无特异性临床表现,但对排除了其它原因的呼吸困难、胸痛等表现后,特别是血气分析有明显低氧血症而临床无法解释时应高度重视,应及早进行肺血栓栓塞症的相关检查,提高早期确诊率,以防误诊和漏诊。

Analysis of the Early Clinical Characteristics in 23 Patients with Pulmonary Thromboembolism

Objective: To explore the early clinical characteristics and early diagnosis tools in patients with pulmonary thromboembolism and to increase the diagnosis rate in the emergency. Methods: The early clinical characteri-stics and the results of investigation were reviewed retrospectively from Jan 2000 to Aug 2005. Results: The typical early clinical presentations included dyspnea(65%), chest pain(36%), syncope26%) and haemoptysis(13%). Arterial gas analysis,electrocardiogram(ECG), serous D-dimer and chest nuclear magnetic resonance(MRI) were important diagnosis tools. The early diagnosis rate is 35%. Conclusion: The early clinical features of the acute pulmonary thromboembolism were non-specific. More attention should be paid to dyspnea and chest pain, in particulary with hypoxemia, and associated investigaions should be timly made in order to increase the diagnosis rate.