CTPA对急性肺动脉栓塞程度及疗效的评价

目的：探讨CT肺血管造影（CTPA）对急性肺栓塞患者的栓塞程度及治疗前后右心功能参数变化评价的价值。方法：收集临床疑诊肺栓塞病例152例，纳入118例，所有病例均行CTPA检查，其中40例为非肺栓塞（WPE组），肺动脉栓塞患者78例，后者结合临床表现分为严重栓塞42例（SPE组），非严重栓塞36例（NSPE组）。SPE组立即行溶栓治疗，NSPE组则行抗凝治疗，于治疗14天后行CTPA复查。以CTPA作为肺栓塞的诊断依据，分析3组之间的心血管参数的差异；分析SPE组与NSPE组的栓塞指数，并探讨其与心血管参数之间的相关性；分析肺栓塞组治疗前后的心血管参数的差异。结果：SPE组的阻塞指数高于NSPE组；对心血管的参数分析发现，WPE组与栓塞组之间有显著性差异，SPE组与NSPE组之间亦有显著性差异。阻塞指数和心血管参数之间的相关性有统计学意义，其中右肺动脉管径与阻塞指数之间的相关系数最高。SPE组与NSPE组治疗前后的心血管参数均有统计学差异。结论：CTPA不仅可以诊断肺动脉栓塞，还可以反映肺栓塞后肺动脉的阻塞程度和右心功能的改变，从而反映预后，且可以观察疗效。

CTPA in evaluating the degree of acute pulmonary obstruction and effect of treatment

Objective:To explore the value of CTPA in grading the severity of acute pulmonary embolism(PE) and to investigate the change of the cardiovascular parameters before and after treatment.Method:152 cases of clinical suspicion of PE,included 118 cases explored by CTPA were studied.The patients were separated into three different groups according to clinical severity and treatment decision:included patients without PE(WPE)(n=40);included patients with severe PE(group SPE) who were treated by fibrinolysis(n=42);...