肺栓塞合并矛盾性栓塞国内文献分析:附一例报告  

Analyses of Paradoxical Embolism Originated from Pulmonary Embolism:Chinese Literature Review and A Case Report

作　　者：蒋德雄 王廷杰[1] 王红军[1] 冉梅[1] 

机构地区：[1]达州市中心医院呼吸科,四川达州635000

出　　处：《中国呼吸与危重监护杂志》2012年第6期588-591,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的综合分析国内肺栓塞合并矛盾栓塞的临床情况,提高对矛盾性栓塞的认识。方法通过检索"万方医学文献数据库"有关肺栓塞合并矛盾性栓塞或反常栓塞的国内文献,结合达州市中心医院收治的1例病例,汇总分析相关临床资料。结果国内文献报道肺栓塞合并矛盾性栓塞患者共51例,男27例,女23例,1例性别不详;年龄23～76岁。发生脑栓塞30例(58.8%),肢体动脉栓塞14例(27.4%),肾动脉栓塞6例(11.8%),卵圆孔血栓骑跨4例(8%),多部位栓塞8例(15.7%),心室骑跨、冠状动脉栓塞、主动脉栓塞及脾栓塞各1例(各1.96%);其中记录卵圆孔开放35例(68.8%),死亡7例(13.7%)。结论对肺栓塞和/或深静脉血栓患者应警惕矛盾性栓塞的可能,加强筛查,减少漏诊。Objective To improve the knowledge of paradoxical embolism originated from pulmonary embolism. Methods The medical literature about pulmonary embolism complicated with paradoxical embolism from 1998 to 2011 was searched from ＂ Wanfang medical literature database＂ Meanwhile 1 case diagnosed in Central Hospital of Dazhou City was reported. Then the clinical characteristics were summarized. Results 51 cases of pulmonary embolism complicated with paradoxical embolism were diagnosed,aged from 23 to 76 years old. There were 27 males and 23 females, and sex was unknown in 1 case. In all cases, the cerebral embolism occurred in 30 cases （58.8%）, lower limb artery embolism in 14 cases（27.4% ） ,kidney artery embolism in 6 cases（ 11.8% ） ,patent foramen ovale with straddling thrombus in 4 cases （8 % ）, multiple embolism in 8 cases （ 15.7% ）, heart ventricle with straddling thrombus in 1 case （ 1.96% ）, coronary artery embolism in 1 case （ 1.96% ）, aorta embolism in 1 case （ 1.96% ）, and spleen embolism in 1 case （ 1.96% ）. There were 35 patients （ 68. 8% ） with patent foramen ovale and 7 cases （ 13.7% ） died. Conclusions Paradoxical embolism waranted more awareness in the cases of pulmonary embolism and/or venous thromboembolism and aggressive screening might avoid misdiagnosis.

关 键 词：肺栓塞 矛盾栓塞 卵圆孔未闭 

分 类 号：R563.5[医药卫生—呼吸系统]