肺血栓栓塞诊治体会  

Diagnosis and Treatment of Pulmonary Thromboembolism

作　　者：张海生[1] 付月云[1] 帖永新[1] 

机构地区：[1]河南省新乡市中心医院呼吸科,453000

出　　处：《职业与健康》2011年第6期715-716,共2页Occupation and Health

摘　　要：目的总结15例肺血栓栓塞患者的诊断和治疗经验。方法分析新乡市中心医院2008年6月—2009年11月15例肺血栓栓塞患者的的临床表现、胸部影像学特征及实验室检查结果。结果 15例患者行CT肺血管造影,全部明确诊断为肺动脉栓塞;临床表现主要是胸闷、胸痛、气短、呼吸困难、心悸,其次是晕厥,下肢疼痛肿胀;血气分析主要表现为低氧血症,其中12例患者D-二聚体监测阳性,心电图、超声心动图及四肢血管彩超检查都有一定的异常;其中12例患者经溶栓及抗凝治疗,11例治愈,1例死亡,余3例仅给予抗凝治疗。结论 CT肺血管造影能明确诊断,危重患者及高危险患者血气分析、D-二聚体、心电图、四肢血管彩超、超声心动图、X线检查等全面综合分析能有效提高肺栓塞诊断率,早期溶栓及抗凝治疗可以达到较好的治疗效果。[Objective]To summarize the experience of diagnosis and treatment of 15 patients with pulmonary thromboembolism. [Methods]The clinical manifestations,chest imaging characteristics and laboratory results of 15 patients with pulmonary thromboembolism in Xinxiang Central Hospital from June 2008 to November 2009 were analyzed. [Results]All of 15 patients were diagnosed as pulmonary embolism by CT pulmonary angiography.The clinical manifestations mainly were chest distress,chest pain,shortness of breath,dyspnea and palpitations,followed by syncope,leg pain and swelling.Blood gas analysis showed that there was mainly hypoxemia.12 patients were positive for D-dimmer,and some abnormalities were detected by ECG,echocardiography and vascular ultrasonography in limbs.12 patients were treated by thrombolysis and anticoagulant therapy,11 cases were cured and 1 case died,and other 3 cases were given only anticoagulant therapy. [Conclusion]CT pulmonary angiography can confirm the diagnosis.The comprehensive and integrated analysis of blood gas analysis,D-dimmer,ECG,vascular ultrasonography in limbs,echocardiography and X-ray examination can improve the diagnosis rate of pulmonary embolism in critical patients.Early thrombolysis and anticoagulant therapy has a better therapeutic effect.

关 键 词：肺血栓栓塞 诊断 治疗方法 

分 类 号：R563.5[医药卫生—呼吸系统]