64例肺栓塞患者临床诊治分析  

Analysis of clinical diagnosis and treatment of 64 patients with pulmonary embolism

作　　者：林苏杰 郝月琴[1] 王芳[1] 唐华平[1] LIN Sujie;HAO Yueqin;WANG Fang;TANG Huaping(Department of Respiratory and Critical Care MedicineⅠ,Qindao Municipal Hospital,Qingdao,Shandong,266011,China)

机构地区：[1]青岛市市立医院呼吸与危重症医学一科,山东青岛266011

出　　处：《临床急诊杂志》2020年第8期619-622,共4页Journal of Clinical Emergency

摘　　要：目的:分析不同严重程度肺栓塞患者的临床特征,以期早期发现肺栓塞并识别其危险分层,给予及时治疗。方法:收集我院64例住院肺栓塞患者的临床资料,将患者分为低危组、中危组、高危组,分析其临床表现、相关检查检验指标及治疗转归情况。结果:肺栓塞病因及诱因包括下肢静脉血栓、高血压、冠心病、骨折术后及肿瘤等;3组患者中晕厥症状、T波倒置、ST段改变及SⅠQⅢTⅢ征、三尖瓣返流、肺动脉高压、D-二聚体及BNP的数值、住院时间、住院费用等方面差异具有统计学意义;在肺栓塞危险程度的ROC曲线中,BNP的AUC值为0.917,D-二聚体的AUC值为0.912,二者联合的AUC值为0.926。结论:肺栓塞常见病因为下肢静脉血栓,不同危险分层的肺栓塞患者,其临床症状、心电图、心脏超声及治疗方式各不相同,通过联合检测肺栓塞患者BNP、D-二聚体水平,可以较好地评估肺栓塞的危险程度。Objective: To analyze the clinical characteristics of patients with pulmonary embolism of different severity, with a view to early detecting pulmonary embolism and identifying its risk stratification, and timely scheduling treatment schemes. Method: The clinical data of 64 inpatients with pulmonary embolism were analyzed, and the patients were divided into low-risk group, medium-risk group, and high-risk group, and their clinical manifestations, relevant examination indexes and treatment outcomes were analyzed. Result: The causes of pulmonary embolism included lower limb venous thrombosis, hypertension, coronary heart disease, postoperative fracture and tumor;There were statistically significant differences in syncope symptoms, T wave inversion, ST segment changes and SⅠQⅢTⅢ sign, tricuspid regurgitation, pulmonary hypertension, D-dimer and BNP values, hospital stays, and hospitalization costs among the three groups of patients;In the ROC curve for evaluating the risk stratification of pulmonary embolism, the AUC value of BNP was 0.917, the AUC value of D-dimer was 0.912, and the combined AUC value of the two was 0.926. Conclusion: The common cause of pulmonary embolism was venous thrombosis in the lower extremities. The combined detection of BNP and D-dimer levels can better assess the risk levels in patients with pulmonary embolism.

关 键 词：肺栓塞 危险分层 临床特征 

分 类 号：R563.5[医药卫生—呼吸系统]