肺栓塞的诊断及无创机械通气干预治疗探讨

目的分析肺栓塞的临床特点和无创机械通气在肺栓塞合并呼吸衰竭中的疗效。方法对我院近5年肺栓塞的临床资料进行回顾性分析。结果大多数肺栓塞患者均存在基础疾病,具典型临床表现者10例(<30%),螺旋CT肺动脉造影(CT-PA)可明确诊断。31例并呼吸衰竭者予无创机械通气,治疗前及机械通气治疗后3d和5d的血气分析、心率及呼吸频率的数值有显著性差异(P<0.01)。结论肺栓塞的临床症状与体征多种多样、缺乏特异性,诊断应提高对肺栓塞的警惕性,综合分析。无创机械通气在肺栓塞合并呼吸衰竭患者中疗效确切,值得临床推广。

The diagnosis and the treatment with noninvasive mechanical ventilation in pulmonary embolism

Objective To analyze the clinical character of pulmonary embolism(PE)and the effects of noninvasive mechanical ventilation in the treatment of pulmonary embolism with respiratory failure.Methods The retrospective analysis to PE patients in the past five years was conducted.Results Most patients had primary diseases.Only 10 cases had the typical clinical symptom(<30%).Helical CT and pulmonary artery angiography(CTPA)was of diagnostic value in pulmonary embolism.31 patients with respiratory failure were treated by noninvasive mechanical ventilation.The measures of blood gas analysis,heart rate and respiratory rate before the treatment were significantly different from those in three and five days after therapy(P<0.01).Conclusion The clinical symptoms of pulmonary embolism are diversified and not specific.We should enhance alertness and synthetical analysis.noninvasive mechanical ventilation is effective in treating pulmonary embolism with respiratory failure,which is worth being recommended for a wider use in clinical practice.