肺结核并发肺栓塞的诊断与治疗  

Diagnosis and treatment for pulmonary embolism in patients with pulmonary tuberculosis

作　　者：盖庆玲[1] 王立华[1] 孙吉昌[1] 

机构地区：[1]山东省胸科医院,济南250013

出　　处：《中国防痨杂志》2007年第6期529-531,共3页Chinese Journal of Antituberculosis

摘　　要：目的探讨肺结核并发肺栓塞(pulmonary embolism,PE)的诊断与治疗方法。方法分析2002年6月—2005年6月诊治的5例肺结核并发PE病例的临床资料。结果5例患者肺结核并发PE后,咳嗽、咳痰、发热加重,并出现胸闷、胸痛、心悸、呼吸困难,查体为呼吸急促、心动过速。经多普勒超声心动图、螺旋CT肺动脉造影检查明确PE诊断。5例确诊时间均已超过溶栓时间,其中1例转外科手术治疗后应用抗凝药物治疗,余4例均给予抗结核治疗同时抗凝治疗。其中1例未坚持服用抗凝药物,2年后再次复发PE抢救无效死亡,余4例病情好转。结论肺结核可并发PE,因临床症状类似,易延误诊断,错过溶栓时间,PE诊断以影像学检查为主,抗凝治疗是最佳治疗方法。Objective To report the experience and to analyze current problems in the diagnosis and treatment of pulmonary embolism(PE) in patients with pulmonary tuberculosis.Methods We diagnosed and treated 5 patients with pulmonary embolism(4 male and 1 female,mean age 48 years old) from June 2003 to June 2006.Symptoms included cough,fever,suffocation,chest pain,palpitation,coma etc.physical signs included tachypnea,tachycardia.We utilized spiral CT pulmonary artery angiography(SCTPA) and Doppler echocardiography to judge PE.Because the chance of thrombolysis has been lost,the anticoagulating therapy was uesed in 5 cases.One of the cases was performed a surgical operation.Results 4 patients recovered with no complication,1 patient died from no using anticoagulant after two years.Conclusion PE is related to the pulmonary tuberculosis.The examination for PE is necessary in patients with pulmonary tuberculosis.The anticoagulating therapy is safe and effective to the patients with pulmonary tuberculosis complicated with PE.

关 键 词：结核 肺/并发症 肺栓塞 

分 类 号：R521[医药卫生—内科学]