基层医院肺血栓栓塞症的临床诊治探讨

目的探讨基层医院对肺血栓栓塞症(PTE)病人的诊断及治疗措施。方法回顾性总结我院近6年来共收治的28例PTE病人临床资料。结果临床表现中以呼吸困难及气促为最常见82.1%,其次为烦躁不安及惊恐感53%,胸痛50%。血气分析为重要诊断筛选手段,阳性率71.4%,超声心电图及胸CT均有重要诊断意义。其中26例行低分子肝素抗凝治疗,18例应用尿激酶(UK)溶栓治疗,好转治愈率75%,症状无明显变化占7.1%,病死率17.9%。结论基层医院临床医师只要提高对PTE的认识,根据实际情况选择必要的实验室检查,掌握抗凝治疗及溶栓治疗的适应证及方法,就可明显降低PTE的病死率。

Investigation for clinical diagnosis and therapy in basic level hospital

Objective To explore the diagnosis and therapy standard of Palmonary Thromboembolism (PTE)in basic level hospital. Methods To retrospectively analyze 28 cases patients with PTE treated in Yankuang Group hospital in recent 6 years. Results Cardinal symptom are dyspneic respiration and anhelation 82.1%,others are dysphoria and panic 53% and chest pain 50%.Arterial blood gases (ABG)is main screening method which has a positive rate of 71.4%,meanwhile,the echocardiogram(ECHO) and chest CT can be a considerable role too. In these cases,26 of them received anticoagulate therapy under the use of low molecular heparin while 18 patients were treated by urokinase (UK) as thrombolytic therapy. The total effective rate was 75%; 7.1% had no striking change and the death rate was17.9%. Conclusions If clinical doctors in basic level hospital improve the cognition of PTE,choose the right accessory examination in accordance to actual need and grasp the indication and method of anticoagulate and thrombolytic therapy,the morality of PTE could be observably decreased.