209例急性肺血栓栓塞临床分析

目的:总结急性肺血栓栓塞(pulmonary thromboembolism,PTE)的临床特征及诊断要点,并分析预后相关预测因子。方法:回顾性分析209例PTE患者的临床资料。结果:PTE患者的常见临床表现为:呼吸困难(79.9%)、胸闷(64.1%)、咳嗽(41.6%)等。仅39.1%的患者首诊诊断为PTE。修订的Wells评分标准可以提高PTE首诊疑诊率,严重指数评分(sPESI)可预测患者预后。结论:PTE的首诊诊断率较低,联合应用Wells评分标准对疑似患者进行评分,可以提高患者的PTE首诊诊断率,及时指导治疗;而采用sPESI危险分层能更准确评估患者死亡风险,有利于对预后的准确判断。

Clinical analysis of 209 cases with pulmonary thromboembolism

Objective：To summarize the clinical features and crucial diagnostic points of acute pulmonary thromboembolism （PTE） and to analyze its prognostic predictors. Methods ： Clinical data of 209 patients with PTE were analyzed retrospectively. Results ： The most common clinical manifestations were dyspnea （ 79. 9% ） , chest distress （64.1%） , cough （41.6%） and so on. Only 39.1% of the patients were diagnosed as PTE on admission. The revised Wells score improved the accuracy of early diagnosis, sPESI might predict the prognosis of patients. Conclusions ： The diagnostic rate of PTE at first visit is low, and thus cause adverse impact on the identification and treatment of the patients. Patients who are suspicious to have PTE can be evaluated by Wells score, thus enhance the initial diagnosis and guide the treatment on time. sPESI risk stratification helps to improve the more correct assessment of the risk of death and beneficial to the accurate judgement of prognosis.