哑型急性肺栓塞的临床研究  

Clinical features of mute type asymptomatic pulmonary embolism

作　　者：方剑[1] 郑琴[1] 王李华[2] 陆炜[2] 田明庆[1] 

机构地区：[1]衢州市人民医院呼吸内科,324000 [2]衢州市人民医院血管外科,324000

出　　处：《浙江医学》2015年第3期226-228,共3页Zhejiang Medical Journal

基　　金：浙江省科技厅项目(2014C34SA900003)

摘　　要：目的：探讨哑型急性肺栓塞（APE）患者的临床特点和预后。方法51例经肺动脉增强CT确诊，但无明显肺栓塞常见临床特征的哑型APE患者予以低分子肝素钠、华法林抗凝治疗。分析患者D-二聚体、血管彩超、心脏彩超、心电图检查结果，并观察治疗后情况，了解哑型APE患者的临床特点及预后。结果51例患者均痊愈出院，4例患者因出现活动性出血停止抗凝治疗。31例患者在3个月后复查肺动脉增强CT未见明显栓塞征象，其余16例患者在4~6月后肺栓塞征象消失。结论哑型APE患者临床表现不典型，肺动脉增强CT检查是明确诊断的金标准，D-二聚体、心电图等可作为相应的补充，经过恰当及时的治疗，患者预后良好。Objective To review the clinical characteristics and prognosis of patients with mute type pulmonary em-bolism. Methods Fifty one patients with mute type pulmonary embolism received anticoagulant treatment with warfarin and low molecular weight heparin sodium. The clinical features of patients were retrospectively reviewed;the findings of D- dimer, vascu-lar ultrasound, ultrasonic cardiogram,electrocardiogram, pulmonary artery enhanced CT were analyzed before and after treat-ment. Results All 51 patients were ful y recovered and discharged from hospital. Anticoagulation therapy was terminated in 4 patients because of active hemorrhage. Thirty one patients had no embolism signs as indicated in enhanced pulmonary CT 3 month after treatment. The embolism signs of the remaining 16 patients disappeared after 4~6month. Conclusion The clinical manifestations of mute type pulmonary embolism were not typical, pulmonary artery enhanced CT is a gold standard for diagno-sis, D- dimer, electrocardiogram can be used as a supplementary diagnostic procedures.The prognosis of the disease should be good with appropriate treatment.

关 键 词：哑型 肺栓塞 肺动脉CT增强 低分子肝素钙 

分 类 号：R563.5[医药卫生—呼吸系统]