肺血栓栓塞症十例临床病理分析  

Clinical-pathological study on 10 cases of pulmonary thromboembolism

作　　者：阮英茆[1] 司文学[1] 张连庄[1] 徐新林[1] 褚雁[1] 王清峙[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院病理科,北京100037

出　　处：《中华结核和呼吸杂志》2003年第2期81-83,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　为帮助临床进一步认识肺血栓栓塞症 (PTE) ,对 10例PTE进行临床病理分析。方法　收集近十年来的 8例PTE尸检资料及 2例外科肺血栓活检资料与临床进行对照分析。结果　10例PTE中 ,年龄 3.5～ 72岁 (平均 33.3岁 ) ,来自先天性心脏病 4例 ,心、肺恶性肿瘤各 1例 ,风湿性心脏病 1例 ,下肢静脉炎 1例 ,另 2例肺动脉血栓来源不明。 10例中仅 2例无心肺血管原发疾病者 ,其临床PTE诊断与病理符合 ,余 8例均未被临床诊断。结论　从本资料分析原有心血管病、心、肺肿瘤及合并肺炎 (肺脓肿 )患者 ,其PTE常被临床漏、误诊。多争取病理检查 。Objective To improve the diagnosis of pulmonary thromboembolism (PTE) by a clinical pathological analysis of 10 cases of PTE. Methods Eight cases of massive and submassive (in the segmental and larger pulmonary arteries) PTE confirmed by autopsy and 2 cases of PTE who underwent surgical treatment in the past 10 years (1991～2001) were studied. The specimens were fixed in 10% buffered formalin, and paraffin sections cut, and stained with HE and ET+VG. The pathological features were analyzed. Results There were 8 males and 2 females, aged 3.5 to 72 years (mean 33.3). The underlining diseases included congenital heart diseases ( 3 cases of ventricular septal defect complicated with pulmonary hypertension, and 1 case of tetralogy of Fallot), malignant lymphoma in the heart ( n =1), rheumatic heart disease ( n =1), lung metastatic cancer from stomach ( n =1), and phlebitis of the legs ( n =1). The sources of PE remained unknown in 2 cases. Among these cases, only 2 were diagnosed clinically. Conclusions The research showed that PTE in patients who had underlining cardiovascular diseases, malignant tumors in the heart or lungs and pneumonia (pulmonary abscess) were hard to diagnose clinically. Pathological study is helpful in improving the clinical diagnosis of PTE.

关 键 词：肺血栓栓塞症 临床病理分析 诊断 治疗 

分 类 号：R563.5[医药卫生—呼吸系统]