32例肺栓塞临床分析  

Clinical anlaysis of 32-case of pulmonary embolism

作　　者：王瑒[1] 张放[2] 

机构地区：[1]沈阳医学院沈洲医院干诊科,110022 [2]中国医科大学附属医院呼吸科

出　　处：《临床肺科杂志》2008年第2期177-178,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨肺栓塞的诊断要点。方法回顾性分析32例肺栓塞的临床特点、诱发危险因素、血气分析、心电图、X线、肺CT扫描、心脏超声检查的特点。结果多数肺栓塞患者存在易患因素以下肢深静脉血栓形成最多占77.8%,其他有长期卧床、高血脂症、慢性心肺疾病、糖尿病等;血气分析检查示低氧血症、心电图检查结果呈典型SⅠQⅢTⅢ、窦性心动过速、右束支传导阻滞等;X线胸片检查表现为肺局部浸润阴影、右下肺动脉增宽、肺动脉段膨出,楔形阴影等;肺螺旋CT示各级肺动脉内有阻塞或不规则偏心性充盈缺损,或者周围性楔形肺实质致密影;超声心动图检查示右室扩大,肺动脉高压。结论目前肺栓塞诊断以临床综合判断为主,任何理化检查均不能单独确定或排除肺栓塞。Objective To discuss of pulmonary embolism the clinical characteristic, assistance inspection and points for the diagnosis. Methods Clinical data were reviewed and analyzed on 32 cases of pulmonary embolisms on its clinical characteristic, inducing risky factor, blood analysis, electrocardiogram, X-ray, lung CT scanning and the heart supersonic inspection characteristic. Results The most pulmonary embolisms patients had the lower limb deep phlebothrombosis （77.8%）, and the rest had the problems of long-term staying in best, high level of blood fat, chronic cardiopulmonary disease, diabetes and so on. The blood analysis inspection showed low level of blood oxygen. The electrocardiogram inspection showed tachycardia, right assume Model SⅠQⅢTⅢ, Dou ties conduction to hinder and so on, X-ray inspection showed that sternum performance partially infiltrated the shadow, the right under pulmonary artery for lung becaming wider, the pulmonary artery sections being swollen, wedge shaped shadow and so on. Lung spiral CT showed that at all levels of pulmonary arteries there were blocks or irregular full of damages, periphery wedge shaped or compact shade. The ultrasonic cardiogram inspection showed that the right room expanded and the pulmonary artery had high pressure. Conclusion At the present time, the diagnosis of pulmonary embolism is mainly based on clinical synthetic judgment and any measures through physics and chemistry examination cant confirm nor exclude the diagnosis of pulmonary embolism.

关 键 词：肺栓塞 临床分析 诊断 

分 类 号：R563.5[医药卫生—呼吸系统]