肺血栓栓塞症临床诊断分析  

Clinical analysis and diagnosis of pulmonary thromboembolism

作　　者：王同生[1] 毛毅敏[1] 娄源杰[1] 孙玉霞[1] 单世民[1] 张英民[1] 张咏梅[1] 潘利娟[1] 

机构地区：[1]河南科技大学第一附属医院呼吸内科,洛阳471003

出　　处：《中原医刊》2007年第10期24-26,共3页Central Plains Medical Journal

摘　　要：目的分析肺血栓栓塞症（PET）患者的发病特点,提高认识和诊断水平。方法对我院2005年1月至2006年10月间确诊的45例PET患者的临床资料进行回顾性分析。结果PET病人近年明显增加,60岁以上PET患者所占比例最高,深静脉血栓形成（DVT）是导致PET的最主要原因,慢性心肺疾患、外科手术、创伤及骨折和恶性肿瘤也是PET的主要危险因素。45例PTE患者中,血气分析示低氧血症者占84.4%,D-二聚体≥500μg/L占97.8%,超声心动图呈典型改变者占23.2%,肺灌注扫描诊断PET阳性率84.2%,CT肺血管造影（CTPA）阳性率96%。结论临床表现多样,常因症状无特异性,需关注其临床特征并结合血气分析、D-二聚体、超声检查、心电图检查作为方便快捷的筛选指标,CTPA、肺灌注通气（Q/V）扫描显像等无创性检查对诊断PET准确可靠,具有重要临床价值。Objective To analyze the clinical manifestation and improve the diagnostic level of PTE. Methods Clinical data of 45 patients with PET in our hospital from Jan. 2005 to Oct. 2006 were collected and retrospectively analyzed. Results There was an increasing trend of incidence of PET in recent years. Deep venous thrombosis（DVT） was a dominant risky factor to PET. The other risky factors included chronic cardiopulmonary disease, surgical operation, trauma, bone fracture and malignant tumors. In all 45 patients with pulmonary thromboembolism, 84. 4% had hypoxe, 97.8% had D- Dimer≥500 μg/L. 23.2% had typical findings on ultrasonic cardiogram,84. 2% had at least one segmental perfusion defect. The positive rate of CT pulmonary angiography（CTPA） were 96%. Conclusion Because the symptoms of PET are unspecitic, it may be difficult to make a clinical diagnosis. The incidence of pulmonary thromboembolism is closely related to the risky factors. A close attention should be paid to the clinnical feature of the disease. Blood gas, D - Dimer and electrocardiograph could be regarded as convenient means for screening patients with PET. Perfusion lung scanning and CTPA are noninvasive and reliable methods for diagnosing PET.

关 键 词：肺血栓栓塞症 诊断 深静脉血栓形成 

分 类 号：R563[医药卫生—呼吸系统]