^(99m)Tc-MAA肺灌注显像对下肢创伤及手术后肺栓塞患者的疗效评价  

Monitoring of Lower Extremital Post-Traumatosis and Pulmonary Thromoboembolism by ～(99m)Tc-MAA Pulmonary Perfusion Imaging Method

作　　者：林晓生[1] 谢昌辉[2] 马志海[2] 朱琳[1] 段清萍[1] 

机构地区：[1]深圳市宝安区中医院骨伤科,深圳518133 [2]南方医科大学附属宝安医院核医学科,深圳518101

出　　处：《热带医学杂志》2007年第6期560-562,共3页Journal of Tropical Medicine

基　　金：深圳市科技局立项资助课题(No.JH200507131032A)

摘　　要：目的利用Tc-大颗粒聚合白蛋白(MAA)肺灌注显像(PPI)监测下肢创伤及手术后(LEPP)肺99m栓塞(PE)患者疗效并对其评价。方法19例临床确诊的LEPP合并PE患者分别于溶栓治疗前、治疗2～4周后进行PPI;PPI图像上显示一个肺段灌注完全缺损记3分,缺损25%～75%记2分,<25%记1分,无异常记0分,根据记分变化分析溶栓治疗前后临床改善情况。结果19例患者溶栓治疗2～4周后临床症状完全消失10例、明显改善6例、有改善3例,治疗前(10.2±3.8)后(2.8±1.4)PPI记分有明显差异(t=7.75,P<0.01)。结论PPI为一种准确、可靠的无创性评价肺血流改善的手段,对LEPP合并PE患者疗效观察具有重要的临床价值。Objective To evaluate the role of pulmonary perfusion imaging （PPI） in thromobolytic therapy of lower extremital posttraumatosis and postoperation patients （LEPP） with pulmonary thmmoboembolism （PE）. Method 19 LEPP with PE （3-28 days of disease course） underwent PPI before thromDolysis and after 2-4 weeks of treatment were included in this study. Lung segment with 100%, 25%-75%, and （25% lack of perfusion was scored as 3, 2, and 1, respectively. Normal segment was scored 0. The therapeutic results were compared with the change of the scores. Result The clinical symptoms of 10 patients were fully disappeared after 2-4 weeks of treatment. 6 patients had significant improvement and 3 patients had improvement. After the treatment （2.8±1.4）, the score was significantly difference from the score recorded before the treatment （10.2±3.8, t=7.75, P〈0.01）. Conclusion PPI is an effective and non-invasive method for evaluating the changes of blood flow in lung. PPI plays an important role in evaluating the therapeutic efficiency in LEPP patients with PE.

关 键 词：下肢创伤/深静脉血栓 肺栓塞 血栓溶解疗法 ^99mTc-大颗粒聚合白蛋白 放射性核素显像 

分 类 号：R563.5[医药卫生—呼吸系统]