肺癌术后肺动脉栓塞的诊治分析

目的：提高肺癌病人开胸术后发生肺动脉栓塞的诊治水平，减少误诊、漏诊。方法：回顾性分析745例肺癌开胸手术患的临床资料，发生13例肺动脉栓塞(1．78％)，列举和分析常见症状、体征，实验室检查、治疗手段。结果：13例患中死亡7例，存活6例，存活6例中均接受静脉肝素抗凝和口服华法令的治疗，其中2例接受尿激酶的溶栓治疗，2例合并巨大肺动脉栓子的病人接受了急诊手术，效果满意。结论：肺动脉栓塞是肺癌术后致命并发症之一，临床表现多样，误诊率较高，须综合分析及早诊断，早期及时有效的治疗是改善预后的关键。

Pulmonary Embolism Following Thoracotomy for Lung Cancer

Objective:To investigate the diagnosis and treatment of pulmonary embolism in patients with primary lung cancer in relation to thoracotomy, and to decrease the rate of leak-diagnosis.Methods:745 cases with primary lung cancer undergoing thoracotomy were retrospectively reviewed.Clinical data of a total of 13 patients (1.78%), suffering from pulmonary embolism.To analysis these 13 patients sign, symptom, laboratory test and treatments. Results: 7 patients were died in 13 cases, the other 6 patients eventually recovered.Of the 6 salvaged patients,they all received anticoagulation with heparin intravenously and warfarin orally, including 2 cases of additional thrombolytic therapy with urokinase.Two cases with massive pulmonary emboli received emergency surgery, and with satisfactory results.Conclusions: Pulmonary embolism is an infrequent but fatal early postoperative complication after lung resection, and clinical manifestations are various.Early diagnosis by thorough analysis of the clinical materials and early treatments are very important to the prognosis for pulmonary embolism patient.