与心血管介入术相关的急性肺栓塞的临床分析  

Clinical analysis of pulmonary embolism related to cardiovascular intervention

作　　者：蔡丽华[1] 苏唏[1] 陈国洪[1] 

机构地区：[1]武汉亚洲心脏病医院,湖北武汉430022

出　　处：《心脏杂志》2006年第6期697-698,701,共3页Chinese Heart Journal

摘　　要：目的分析心血管介入术后发生急性肺栓塞的临床特点和危险因素，提出预防和处理的措施。方法结合我院发生的两例介入术后急性肺栓塞患者，回顾分析了1998—2004年国内文献资料报道的同类病例，共30例患者。统计介入手术项目、肺栓塞临床表现、实验室检查方法、治疗及治疗后效果等。结果冠状动脉造影术后的急性肺栓塞13例，经皮冠状动脉腔内成形术及支架术后7例，射频消融术后9例，冠脉造影＋射频消融术后1例，主要临床表现为呼吸困难、心跳加快、胸痛、咳嗽、晕厥、咯血和低血压。大部分患者并发有下肢深静脉血栓形成，部分患者下肢静脉曲张病史。检查手段包括心电图、心脏超声、胸片、动脉血气、D-2聚体、放射性核素显像检查、肺动脉造影、肺动脉磁共振（或增强CT）等。死亡3例。结论心血管介入术后并发急性肺栓塞病情重而危急，尽早诊断、尽早治疗可挽救患者生命，并应加强预防措施。AIM To analyse the clinical and risk factor of acute pulmonary embolism after cardiovascular intervention and to find out methods of treatment and prevention. METHODS Thirty cases of all acute pulmonary embolism after cardiovascular intervention were included in the study, two of whom were from our hospital and others were from previously reported cases during 1998 -2004 in China. We analysed the types of intervention, clinical characteristics, laboratory examinations, and treatment and the effects. RESULTS Thirteen cases had acute pulmonary embolism after coronary arteriography（ CAG）, 7 cases after percutaneous coronary intervention（ PTCA ＋ STENT）and 9 cases after radiofrequency catheter abla- tion （RFCA）. Only one case was after CAG ＋ RFCA. The diagnosis was based on the results from examination by D-Dimers, ECG, uhrocardiogrophy, leg vein Doppler, perfusion lung scanning and selective pulmonary angiography, CT and MRI. Three cases died. CONCLUSION The risk rate of acute pulmonary embolism after cardiovascular intervention is higher. Effective measures should be taken to prevent it.

关 键 词：肺栓塞 急性 心血管介入术 

分 类 号：R541.1[医药卫生—心血管疾病]