超声诊断急性肺栓塞及溶栓疗效评价中的应用  

Application of Ultrasound in diagnosis of acute pulmonary embolism and the evaluation of thrombolytic therapy

作　　者：黄美蓉[1] 葛艳[1] 张世科[1] 

机构地区：[1]福建医科大学附属厦门第一医院超声影像科,361003

出　　处：《中国实用医药》2009年第25期59-60,共2页China Practical Medicine

摘　　要：目的探讨超声在诊断急性肺栓塞(PTE)及其对溶栓后疗效的评价。方法临床疑似PTE的35例患者进行超声心动图和下肢深静脉超声检查。经临床表现、心电图、超声、核素、螺旋CT、肺动脉造影综合检查后确诊的较大面积肺栓塞的25例接受溶栓抗凝治疗。比较溶栓前、溶栓后2周、溶栓后3个月心脏及下肢深静脉血栓的变化情况。结果超声心动图诊断PTE的直接征象(肺动脉血栓)2例,间接征象23例,无异常变化10例。溶栓后2周超声相关的主要监测指标(右室舒张末前后径RVEDD,右房舒张末上下径RADD,肺动脉主干内径MPA,肺动脉血流峰值速度VPA,肺动脉血流加速时间AT,三尖瓣反流峰值速度Vp,肺动脉收缩压PASP)与溶栓前参数比较明显好转(P<0.05),具有统计学意义。3个月后有8例超声的各项指标正常,其余与溶栓后2周的参数值比较无统计学差异。下肢深静脉检查18例32条血管内血栓。溶栓治疗后12例有效,管腔大部分再通,6例无效。结论超声诊断急性肺栓塞安全、无创、可靠,并且可作为溶栓疗效评价和长期随诊的工具。Objective To explore the application of Ultrasound in the diagnosis of acute pulmonary embolism and the evaluation of thrombolytic therapy. Methods Clinical PTE suspected of 35 cases of patients with echocardiography and deep venous uhrasonography. A larger area of the 23 cases of pulmonary embolism confirmed by the comprehensive examination with clinical, ECG, ultrasound, nuclide, CT, pulmonary angiography, received thrombolytic anticoagulant treatment. Compaired the heart and deep vein thrombosis changes before thrombolytie therapy, and in thrombolytic therapy after 2 weeks, after 3 months. Results The echocardiogram diagnoses PTE of the direct sign （pulmonary artery thrombus） were in 2 cases, the indirect sign in 16 cases, no abnormal changes in 5 cases. The indicators of ultrasound obviously became better after 2 weeks by thrombolysis, and each indieadors bacame normal in 8 cases after 3 months. 18 cases of 32 of vascular thrombosis were checked out by deep venous ultrasonography. 12 cases were effective after thrombolytic therapy with most of the luminal reeanalization, and 6 cases were invaild. Conclusions Ultrasound diagnosing acute pulmonary embolism is safe,non-invasive,reliable and can be served as a tool for long-term follow-up in evaluation of thrombolytie therapy.

关 键 词：超声诊断 肺栓塞 疗效评价 

分 类 号：R563.5[医药卫生—呼吸系统] R445.1[医药卫生—内科学]