^(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观察  

Thromobolytic Therapeutic Evaluation on Lower Extremital Posttraumatosis and Postoperation Patients with Pulmonary Thromboembolism by ^(99m)Tc-MAA Pulmonary Perfusion Imaging

作　　者：谢昌辉[1] 马志海[1] 朱琳[1] 林晓生[1] 段青萍[1] 

机构地区：[1]南方医科大学附属宝安医院,广东深圳518101

出　　处：《实用预防医学》2010年第3期542-543,共2页Practical Preventive Medicine

基　　金：深圳市科技计划项目(项目编号:JH200507131032A)

摘　　要：目的利用99mTc-大颗粒聚合白蛋白(MAA)肺灌注显像(PPI)监测肺下肢创伤及手术后(LEPP)肺栓塞(PE)患者的疗效。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记分差异有统计学意义(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 investigate the role of pulmonary perfusion imaging （PPI） in evaluating the thromobolytic therapy in lower extremital posttraumatosis and postoperation （LEPP） patients with pulmonary thromboembolism （PE）. Methods Nineteen LEPP patients with PE underwent PPI before thrombolysis and after 2～4 weeks of treatment. The lung segments with 100% lack of perfusion was marked 3,those demonstrated 25%～75% marked 2,25% marked 1 and normal marked 0. The therapeutic results were compared according to the changes of marks. Results Ten patients＇ clinical symptoms fully disappeared after 2～4 weeks of treatment,6 significant improved,and 3 improved. There were statistically significant differences in PPI marks between before （10.2±3.8） and after （2.8±1.4） treatment （t=7.75,P0.01）. Conclusions PPI is an effective and noninvasive method for evaluating the changes of lung blood flow,and plays an important role on 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：R977.1[医药卫生—药品]