急性肺栓塞患者的血栓分布特征分析  

Anatomic distribution of embolus at CT pulmonary angiography in patients suspected acute pulmonary embolism

作　　者：朱力[1] 王建国[2] 刘敏[3] 郭晓娟[3] 郭玉林[1] 翟晓辉[4] 郭佑民[4] 王辰[5] 

机构地区：[1]宁夏医科大学附属医院放射科,银川750004 [2]深圳市第五人民医院放射科 [3]首都医科大学附属朝阳医院放射科 [4]西安交通大学医学院第一附属医院医学影像中心 [5]卫生部北京医院

出　　处：《中华结核和呼吸杂志》2012年第11期833-836,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家“十一五”科技攻关项目（2006BA101A06）;国家自然科学基金（30960098）;宁夏科技攻关计划项目（XZ201008）

摘　　要：目的总结和分析急性肺栓塞患者的血栓形态和分布特点。方法回顾性分析279例怀疑急性肺栓塞患者的CTPA图像，分析中央型血栓、周围型血栓和混合型血栓的发生率；血栓在不同级别的肺动脉内的分布特点；以及不同级别的肺动脉内血栓的形态学特点。结果279例急性肺栓塞患者中，男158例，女121例，年龄17～85岁，中位数63岁。中央型肺栓塞患者占3．5％，周围型肺栓塞患者占40．9％，混合型肺栓塞患者占55．6％。279例急性肺栓塞患者在肺段动脉以上血管内共发现血栓1850个，右肺动脉内占58．2％（1075／1850），左肺动脉内占41。8％（772／1850）；其中双肺上叶血栓占29．7％，右肺中叶和左舌叶血栓占18．3％，双肺下叶血栓占49．8％。A、B和C型血栓数的百分比分别为81．7％、7．6％和10．7％。结论单纯周围型血栓并不少见，采取薄层CTPA扫描能够提高对周围型血栓的检出。血栓的分布与血流的分布一致，右肺较左肺多，下肺较上肺和中肺多。Objective To summarize and analyse the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography（CTPA） imagings of 279 patients suspected acute pulmonary embolism were analysed retrospectively in Ningxia from January 2004 through June 2006 and in Beijing from September 2005 through October 2006. The incidence of central embolus, peripheral embolus and mixed embolus, and the distribution and the morphology of embolus in different levels of pulmonary arteries were analysised. Results A total of 279 patients （ 158 males, 121 females; Median age was 63 years） were recruited. The incidence of central embolus, peripheral embolus and mixed embolus were 3.5% , 40. 9% and 55.6% , respectively. There were 1850 emboli found above the segmental pulmonary arterial, 58.2% were found in right pulmonary artery, and 41.8% in left pulmonary artery. For all of the emboli, there were 29.7% in bilateral upper lobes, 18.3% in midial lobe and lingual lobe, and 49.8% in bilateral lower lobes. The percent of A, B and C type embolus were 81.7% ,7.6% and 10. 7% , respectively. Conclusion It was not unusual for the peripheral thrombosis, and can be improved to detect peripheral thrombosis by thin-slice CT scan. The distribution of embolus in pulmonary vascular and the distribution of blood flow was consistent, the number of embolus in right lung were more than left lung, and lower lobes more than upper lobes and middle lobes.

关 键 词：急性肺栓塞 血栓 体层摄影术 X线计算机 

分 类 号：R563.5[医药卫生—呼吸系统]