肺血栓栓塞症18例临床分析

目的:探讨肺血栓栓塞症危险因素与发病的关系,提高对肺血栓栓塞症的诊断及治疗水平。方法:对1993年元月～2002年12月确诊的18例肺血栓栓塞患者的易患因素、临床表现、辅助检查、治疗方法进行临床回顾分析。结果:肺血栓栓塞症的临床表现差异较大,容易误诊,本组误诊率达52.9%,本组有11例死亡,病死率61.1%,6例患者经手术、溶栓及抗凝治疗后存活,1例自动出院。深静脉血栓形成是本组肺血栓栓塞症发生的主要原因。结论:肺血栓栓塞症的发病率与易患因素密切相关,综合医院临床医师应提高对肺血栓栓塞的警惕性,仔细查找病因,常规X线、动脉血气分析、心电图、血管超声等均有助于其诊断,但肺灌注显像及螺旋CT更方便可靠。

Clinical analysis of eighteen patients with pulmonary embolism

Objective:To investigate the relationship between the risk factors and onset of pulmonary embolism and to develop a proper diagnostic strategy and clinical management for patients with pulmonary embolism.Methods:Predisposing factors, clinical manifestation, treatment and out comes of 18 consecutive patients with established pulmonary embolism were analyzed retrospectively.The patients were definitely diagnosed in our hospital from 1993 to 2002.Results:Four of these patients were confirmed by autopsy, two by operation, the other twelve cases were diagnosed by clinical manifestation combined with ultrasonic cardiogram, perfusion-inspiration lung scans, chest roentgenogram, CT and pulmonary Angiography. The mortality rate was 61.1% for pulmonary embolism (11of them died),6 of the patients survived after treatment,One discharged on reguest.Conclusions:The incidence of pulmonary embolism is closely related to the associated factors. CT scan,deep vein Doppler echogriaphy play important role in diagnosis.Thrombolytic treatment can improve the survival rate of patients with pulmonary embolism.