21例肺动脉栓塞症的临床分析

目的总结肺栓塞临床表现与诊疗体会，提高对肺栓塞的认识，减少临床漏诊及误诊率。方法回顾性分析21例肺栓塞患者的临床表现，诊断及治疗方法比较。结果21例患者中1例临床诊断，20例由CT肺动脉造影（CT-PA）确诊。其中7例接受溶栓＋抗凝治疗，13例仅接受抗凝治疗，两组治疗有效率差异无统计学意义（P〉0．05）。结论肺栓塞的临床表现缺乏特异性，D-二聚体阴性可以基本除外急性肺栓塞，CT肺动脉造影（CTPA）是首选的确诊手段。提高对PE患者的诊断意识，及时有效的规范化治疗，是临床提高PE患者救治成功率的关键。

Clinical Analysis for 21 Patients with Pulmonary Embolism

Objective To summarize the clinical manifestations, diagnosis and therapy of acute pulmonary embolism for improving our realization on it, and lowering the rate of missed diagnosis and misdiagnosis. Methods Retrospectively analyzed the clinical manifestation, diagnosis and treatment of 21 cases with pulmonary embolism from July 2007 to January 2010 in my hospital. Results One case was diagnosed by clinical manifestations ,20 cases were diagnosed by CTPA （computer tomography pulmonary arteriography, CTPA）. Seven cases received thrombolysis and anticoagulant therapy, and 13 cases only received anticoagulant therapy. There was no significantly difference in the effective rate between the two methods. Conclusion The clinical manifestations of acute pulmonary embolism have no special. A negative D-dimer test result may strongly suggest that PE is absent. CTPA is preferred final diagnosis. Physicians should pay more attentions to PE in order to improve a diagnostic accuracy. The standard therapy may improve the prognosis significantly.