发生急性肺栓塞的临床表现及危险因素  

Clinical characteristics and risk factors of pulmonary embolism

作　　者：龙文[1] 王玉梅[2] LONG Wen(Department of Respiratory Medicine,Shihezi People's Hospital,Shihezi,Xinjiang,832000,China)

机构地区：[1]石河子市人民医院呼吸内科,新疆石河子832000 [2]石河子绿洲医院,新疆石河子832000

出　　处：《齐齐哈尔医学院学报》2019年第11期1363-1365,共3页Journal of Qiqihar Medical University

摘　　要：目的分析肺栓塞临床特点和相关危险因素,为医生进行早期临床干预提供依据。方法选取2016年6月-2018年6月本院收治的260例肺栓塞患者作为研究对象,回顾性分析患者年龄、性别、既往病史、相关检查等一般资料,总结肺栓塞临床特点,运用Logistic回归分析导致肺栓塞相关危险因素。结果 260例肺栓塞患者90%以上临床症状均为咳嗽咳痰、呼吸困难及心悸等表现,差异无统计学意义(P<0.05)。血气分析结果提示,152例(58.46%)患者二氧化碳分压(CO2分压)<60 mm Hg;82例(31.53%)患者CO2分压<80 mm Hg;血生化指标结果提示,257例(98.84%)患者D-二聚体>500μg/L;48例患者血小板>300×109/L;31例患者白细胞水平>10×109/L。心电图检查结果提示,75例患者异常Q波、S-T段抬高。79例患者出现异常Q波和T波倒置。影像学检查结果提示,149例患者存在肺动脉高压。单因素分析结果提示,引发肺栓塞的危险因素为冠心病、高血压、高脂血症等差异具有统计学意义(P<0.05)。结论临床上引发肺栓塞的高危因素较多,且肺栓塞的临床症状较为严重,且无特异性表现,因此在临床上进行肺栓塞患者病情评估时,要结合患者既往病史、年龄、血生化以及血气指标进行分析,及早治疗。Objective Analysis on clinical characteristics and related risk factors of pulmonary embolism,to provide evidence for doctors for early clinical intervention. Methods 260 patients with pulmonary embolism admitted to our hospital from June 2016 to June 2018 were selected for experimental study,general data such as age,sex,disease history,related examination were reviewed,clinical features of pulmonary embolism were summarized,and risk factors related to pulmonary embolism were analyzed by logistic regression. Results More than 90% of the patients with pulmonary embolism had cough,phlegm,dyspnea,palpitations,etc. There was no significant difference( P<0.05). The results of blood gas analysis indicate that 152 patients( 58.46%) had carbon dioxide partial pressure( CO2 partial pressure) lower than 60 mm Hg.In 82 cases( 31.53%),CO2 partial pressure less than 80 mm Hg. The results of blood biochemical indicators suggested that 257 patients( 98.84%) had Ddimer over 500 μg/L.48 patients with platelet above 300 × 109/L. White blood cell level over10 × 109/L in 31 patients.The results of the electrocardiogram showed that 75 patients had abnormal Q wave and S-T segment elevation.In 79 patients,abnormal Q wave and T wave inversion occurred.The results of imaging showed that 149 patients had pulmonary arterial hypertension.The results of Logitic regression analysis indicate that the risk factors for pulmonary embolism were coronary heart disease,hypertension,hyperlipidemia,and the differences of statistical significance( P<0.05). Conclusions There are many high risk factors for pulmonary embolism,and the clinical symptoms of pulmonary embolism are serious and there is no specific manifestation. Therefore,when the patient with pulmonary embolism is evaluated clinically,it is necessary to analyze the patient’s past disease history,age,blood biochemistry and blood gas indicators and give treatment as early as possible.

关 键 词：肺栓塞 危险因素 临床特点 

分 类 号：R563.5[医药卫生—呼吸系统]