48例肺动脉栓塞的诊治分析

目的:探讨肺动脉栓塞的临床特点和诊断方法,提高其诊断水平。方法:回顾分析48例确诊为肺动脉栓塞病例的临床资料。结果:肺动脉栓塞以中老年患者居多,常伴有多种危险因子(如深静脉血栓形成(35.40%)、心血管疾病(40.20%)、恶性肿瘤(12.50%)、外科手术(14.60%)后等)。临床表现不典型,多表现为不明原因的呼吸困难(93.3%)及胸痛(62.5%).部分患者可表现为休克(10.4%)及晕厥(14.6%)。动脉血气分析、血D-二聚体检查、心电图、胸片、超声心动图对肺栓塞的诊断有提示作用;而同位素肺灌注/通气扫描、螺旋CT及肺动脉造影是确诊肺栓塞的较为可靠的诊断方法。结论:肺动脉栓塞是一种常见的肺血管疾病,有较高的病死率。对有症状的高危患者应尽早给予同位素肺灌注/通气扫描和螺旋CT检查以明确诊断。

Clinical Features and Diagnostic Approach on 48 Cases of Pulmonary Embolism

Objective:To explore the clinical features and diagnostic approaches of pulmonary embolism for improving the diag- nostic ability.Methods:Clinical data of 48 patients with pulmonary embolism were analyzed retrospectively.Results:The pa- tients of pulmonary embolism often had risk factors.such as deep venous thrombosis,cardiacvascular disease or malignant tumors.The most frequently seen symptoms were sudden onset of dyspnea and chest pain.The eommon examinations include blood gas analysis,D-dimer testing,electrocardiogram,chest X-ray and ultrasonography,which were predictive for the diagno- sis of pulmonary embolism.Lung ventilation/perfusion scan,spiral CT and pulmonary arteriography were reliable methods in its diagnosis.Conclusion:Pulmonary embolism was a common disease.High risk patients with symptoms shoud receive exami- nations such as lung ventilation/perfusion scan and spiral CT.