超声心动图对肺动脉栓塞的诊断价值  

Diagnostic value of echocardiography in pulmonary artery embolism

作　　者：王慧[1] 李洪忠 张文花[3] WANG Hui;LI Hong-zhong;ZHANG Wen-hua(Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学第二附属医院,250001 [2]山东大学附属省立医院,250021 [3]山东大学附属千佛山医院,250014

出　　处：《中国实用医药》2020年第9期22-24,共3页China Practical Medicine

摘　　要：目的探讨肺动脉栓塞的超声心动图特点,为准确诊断和及早制定治疗方案提供参考。方法回顾性分析经临床综合诊断确诊的12例肺动脉栓塞患者的临床特点和超声心动图检查结果特征。结果经超声心动图直接确诊5例,其中3例分别在主肺动脉、左肺动脉或右肺动脉, 2例右房发现栓子;间接诊断6例,右房右室增大,主肺动脉和(或)左右肺动脉增宽,三尖瓣返流及肺动脉高压。结论肺动脉栓塞大部分患者出现明显临床症状及体征,但有少部分患者并没有明显右心系统不适症状出现,这部分患者存在更大的潜在隐患。在声窗条件允许的情况下,在肺动脉内扫查到清晰的栓子,可以明确诊断肺动脉栓塞。在不能直接确诊的情况下,也可以通过右心系统的超声心动图变化,为肺栓塞的诊断提供有价值的诊断依据。Objective To evaluate the echocardiographic characteristics of pulmonary embolism, and to provide reference for accurate diagnosis and early treatment. Methods The clinical features and echocardiographic findings of 12 patients with pulmonary embolism confirmed by clinical comprehensive diagnosis were retrospectively analyzed. Results 5 cases were directly diagnosed by ultrasound, of which 3 cases were in the main pulmonary artery, left pulmonary artery or right pulmonary artery, embolism was found in 2 cases in the right atrium. 6 cases were indirectly diagnosed, with enlarged right atrium and right ventricle, widened main pulmonary artery and/or left and right pulmonary artery, tricuspid regurgitation and pulmonary hypertension. Conclusion Most patients with pulmonary embolism have obvious clinical symptoms and signs, but a few patients do not have obvious right heart system discomfort symptoms, which has a greater potential risk. Pulmonary embolism can be clearly diagnosed by scanning a clear embolus in the pulmonary artery, as permitted by the acoustic window conditions. In the case of no direct diagnosis, the echocardiographic changes in the right heart system can also provide a valuable diagnostic basis for the diagnosis of pulmonary embolism.

关 键 词：超声心动图 肺动脉栓塞 诊断价值 

分 类 号：R563.5[医药卫生—呼吸系统]