下肢创伤并发肺栓塞溶栓效果的^(99m)Tc-MAA肺灌注显像观察  

The Thromobolytic Therapeutic Evalution in Lower Extremital Posttraumatosis and Postoperation Patients with Pulmonary Thromoboembolism by ^(99m)Tc-MAA Pulmonary Perfusion Imaging

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,广东深圳518133 [2]南方医科大学附属宝安医院核医学科,518101

出　　处：《中国误诊学杂志》2007年第20期4700-4702,共3页Chinese Journal of Misdiagnostics

基　　金：本课题获深圳市科技计划项目(编号:深科信2005-227-250)

摘　　要：目的:利用99mTc-大颗粒聚合白蛋白(MAA)肺灌注显像(PPI)观察下肢创伤及手术后(LEPP)并发肺栓塞(PE)患者的溶栓疗效。方法:19例临床确诊的LEPP并发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记分差异有显著性(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患者疗效观察具有可靠的临床价值。Objective：To investigate the role of pulmonary perfusion imaging（PPI） in evaluating the thromobolytic therapy in lower extremital posttraumatosis and postoperation patients （LEPP） with pulmonary thromoboembolism （PE）. Methods： 19 LEPP with PE （3-28 days disease course） underwent PPI before thrombolysis and after 2-4 weeks＇ treatment. The lung segments with 100 % lack of perfusion was marked 3,those denmonstated 25 % - 75 % marked 2,〈 25% marked 1 and normal marked 0. The therapeutic results were compared with the marks＇ changes. Results：The clinical symptoms of 10 cases were fully disappear after 2-4 weeks＇ treatment, 6 significant improved, 3 improved. The marks were significant difference between before（10.2±3. 8） and after（2.8±1.4） treatment（t= 7.75,P〈0.01）. Conclusion：PPI is an effective and noninvasive method for evaluating changes of lung blood flow,it could play an important role on evaluating therapeutic efficiency in LEPP with PE patients.

关 键 词：下肢/损伤 肺栓塞/并发症/药物疗法/放射性核素显像 血栓溶解疗法 肺/放射性核素显像 99m锝聚集白蛋白/诊断应用 人类 

分 类 号：R563.5[医药卫生—呼吸系统] R64[医药卫生—内科学]