老年肺栓塞40例临床分析  

Clinical analysis of pulmonary embolism in 40 elderly patients

作　　者：周卫华[1] 徐晓龑[2] 

机构地区：[1]江苏省老年医院急诊科,江苏省南京市210024 [2]东南大学附属中大医院风湿科,江苏省南京市210009

出　　处：《实用老年医学》2012年第4期309-311,共3页Practical Geriatrics

基　　金：江苏省卫生厅"科教兴卫"重点实验室开放课题(KF200949)

摘　　要：目的探讨老年人肺栓塞的临床特点。方法采用病例对照分析40例≥60岁肺栓塞患者与36例<60岁肺栓塞患者的临床表现和检查特点。结果老年组肺栓塞患者多有基础疾病或危险因素,依次为高血压、下肢静脉血栓形成、脑梗死、冠心病、恶性肿瘤、术后卧床等,而非老年组患者半数没有基础疾病。老年肺栓塞患者常见症状为呼吸困难、胸闷,相对于非老年患者咯血和胸痛较少。部分肺栓塞患者以晕厥首发。超声心动图检查显示老年组肺栓塞患者出现肺动脉压升高、右心系统扩大和肺动脉增宽者的比例高于非老年组患者。结论老年肺栓塞最常见的危险因素为高血压和下肢深静脉血栓形成,其临床表现以呼吸困难首发多见。Objective To explore the clinical characteristics of pulmonary embolism（PE） in patients more than 60- year-old. Methods The clinical manifestations and diagnostic techniques were analyzed retrospectively in 40 elderly pa- tients （ ≥60 years） with PE and 36 younger patients（ 〈 60 years） with PE. Results Most of the elderly PE patients in this study suffered from chronic diseases or risk factors, such as hypertension, deep venous thrombosis （DVT） in lower limbs, brain infarction, coronary artery disease, malignant tumor and lying in bed afteroperation, but half of younger pa- tients with PE had no underlying diseases. The common clinical manifestation of the elderly patients with PE induded dysp- nea and chest tightness. Compared with younger patients, chest pain and hemoptysis were less. Syncope was the first clini- cal manifestation in some patients. The proportion of pulmonary hypertension, expansion of the right heart system and wid- ened pulmonary artery demonstrated by echocardiography in the elderly patients with PE was higher than that of younger pa- tients with PE. Conclusions The most common risk factors of PE in the elderly are hypertension and DVT in lower limbs. Dyspnea is the primary clinical manifestation.

关 键 词：肺栓塞 老年人 症状 

分 类 号：R563.5[医药卫生—呼吸系统]