肺血栓栓塞症15例临床分析  

Clinical analysis of 15 cases with pulmonary thromboembolism

作　　者：孙丽丽[1] 

机构地区：[1]辽宁医学院附属第一医院呼吸二病区,辽宁锦州121000

出　　处：《中国民康医学》2014年第13期41-42,共2页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨15例肺血栓栓塞症(PTE)患者的危险因素、临床特点和治疗方案。方法:收集15例肺血栓栓塞症(PTE)患者的临床治疗,分析其临床表现、实验室检查、治疗及转归情况。结果:15例肺血栓栓塞症(PTE)患者中,突发呼吸困难和呼吸困难加重13例,晕厥3例,患者的主要临床表现为典型呼吸困难、胸痛及咯血1例,长时间制动4例,手术患者2例,口服避孕药1例。化验检查D-二聚体>500μg/L及血气分析低血氧饱和度者15例,肺动脉增强CT造影(CTPA)异常15例,溶栓治疗13例,抗凝治疗2例,症状改善不明显2例。结论:肺血栓栓塞症的发生与长期肢体制动、口服避孕药等有关,临床表现多样,典型三联症不多见,心电图及血气分析异常特异性差,肺动脉增强CT造影为确诊首选诊断方法。诊断及时及积极治疗预后良好。Objective：To investigate risk factors, clinical characteristics and treatment protocols for 15 patients of pulmonary thromboembolism （ PTE） . Methods：The clinical treatments of 15 PTE patients were collected, and their clinical manifestations, labo-ratory examinations, and treatments and outcomes were analyzed. Results：Among the 15 PTE patients, there were 13 cases with sud-den dyspnea and aggravated dyspnea and 3 cases with syncope. The main clinical manifestations were dyspnea, thoracalgia and hemop-tysis （1 case）, braking for a long time （2 cases）, surgical patients （2 cases）, and oral contraceptive patient （1 case）. There were 15 cases with blood oxygen saturation （ through blood gas analysis） according to the examination of D-dimer of 〉500μg/L. 15 cases were abnormal in pulmonary arterial enhancement CT angiography, 13 cases were given thrombolytic therapy, 2 cases received antico-agulant therapy, and the symptom improvement was not obvious in 2 cases. Conclusions：PTE is related to long term limbs braking and oral contraceptives, etc. The clinical manifestations are various, the typical triad is rare, and the specificities of abnormal electrocardi-ogram and blood gas analysis are poor. Therefore, pulmonary arterial enhancement CT angiography is the preferred diagnostic method. If the diagnosis is done without delay, the prognosis will be good.

关 键 词：肺血栓栓塞 诊断 溶栓 

分 类 号：R563.5[医药卫生—呼吸系统]