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目的:探讨肺动脉栓塞(PE)患者的临床表现、诊断、治疗和预后。方法:对本院121例PE患者资料行回顾性分析,着重分析患者的临床表现、诊断、治疗和预后。结果:PE患者有增加趋向,存在易患因素,下肢深静脉血栓形成为最常见的因素。临床表现多为不明原因的呼吸困难、胸痛、咯血、咳嗽、晕厥及休克等。溶栓治疗24例,存活21例;介入治疗11例,存活8例;单纯抗凝治疗86例,存活77例。结论:PE患者症状、体征和临床表现不完全一致,提高对PE的认识,对及时诊断PE具有重要意义;对疑诊的患者应常规筛查心电图、血气分析、血液生化、D-二聚体及超声心动图;高度怀疑者进一步检查肺部螺旋CT增强扫描及肺动脉造影。尿激激酶静脉溶栓及低分子肝素及华法林抗凝治疗效果良好。
Objective: To investigate the clinical manifestations, diagnosis, treatment and prognosis of patients with pulmonary embolism (PE). Methods: The data of 121 PE patients in our hospital were analyzed retrospectively. The clinical manifestations, diagnosis, treatment and prognosis were analyzed emphatically. Results: PE patients have an increasing trend, there are predisposing factors, deep venous thrombosis of the lower limbs is the most common factor. Clinical manifestations and more unexplained breathing difficulties, chest pain, hemoptysis, cough, fainting and shock. Thrombolytic therapy in 24 cases, 21 cases of survival; interventional treatment in 11 cases, 8 cases of survival; anticoagulant therapy in 86 cases, 77 cases of survival. Conclusion: The symptoms, signs and clinical manifestations in patients with PE are not exactly the same. It is of great significance to diagnose PE in a timely manner to improve the understanding of PE. Patients with suspected PE should be routinely screened for electrocardiogram, blood gas analysis, blood biochemistry, D-dimer And echocardiography; a high degree of skepticism further examination of enhanced lung CT scan and pulmonary angiography. Urokinase intravenous thrombolysis and low molecular weight heparin and warfarin anticoagulant effect is good.