藏族患者肺栓塞1例

通过对一例高原藏族D-二聚体阴性肺栓塞患者的病因、临床表现、诊断和治疗进行临床分析和总结，证实在高原低氧环境下，血流缓慢、血粘滞度升高，易引起血液流变学及动力学改变，同时伴有红细胞压积增高，使血液处于高凝状态，易致血栓形成。高原肺栓塞起病隐匿，D-二聚体作为急性肺栓塞筛选检查，阴性预测值较高，但即使D-二聚体阴性，亦需结合肺栓塞Wells量表与Geneva量表进行评估、筛查，以提高基层医院的诊断率和确诊率。

A case report of Tibetan patient with pulmonary embolism

The etiology of a case of plateau Tibetan D-dimer-negative patient with pulmonary embolism and clinical manifestations and diagnosis and treatment of clinical analysis and summary, plateau hypoxia environment and slow blood flow increased blood viscosity and easied to cause the rheology and dynamics change and accompanied by increased hematocrit, the blood in a hypercoagulable state and proned to cause thrombosis. Plateau pulmonary embolism onset, D-dimer was a screening factor for acute pulmonary embolism, the negative predictive value was higher, but even negative D-dimer, also needed to combine the assessment of pulmonary embolism Wells Scale and Geneva Scale sievethe investigation, in order to improve the diagnosis rate and the rate of diagnosis of the primary hospital.