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目的 探讨急诊肺栓塞 (PE)快速、准确、实用的诊断方法。方法 对 52例确诊为急性肺栓塞的急诊患者的发病原因、临床症状、体征、化验室检查、X线、ECG、U CG、肺通气 /灌注扫描(V/Q)等进行回顾性分析和总结。结果 血气分析、D- 聚体 (D- Dimer)测定是 PE的初步筛选手段 ,阳性率 Pa O2 为 6 5.9% ;Pa CO2 为 53.1% ;D- Dimer为 70 %。X线胸片可作为提示性依据 ,非特异性片状阴影出现率为 4 3.5%。ECG特异性改变 (S Q T )发生率仅为 3.8% ,只可作为 PE的参考依据。UCG能较明确地反映 PE的右室负荷增加征象 ,肺动脉直径增宽发生率为 75% ;右心室扩大 94 .4 % ;肺动脉高压 6 4 % ;V/Q可作为急诊诊断 PE较为可靠的手段 ,阳性率达 10 0 %。结论 对以呼吸困难、气短等呼吸系统症状就诊的急诊患者 ,应提高对 PE的警惕 ,按上述程序进行综合检查 ,可以快速、准确、实用地对 PE做出诊断
Objective To explore a rapid, accurate and practical diagnostic method for emergency pulmonary embolism (PE). Methods Retrospective analysis and summary of the etiological factors, clinical symptoms, signs, laboratory tests, X-ray, ECG, U CG, V / Q and so on were performed in 52 patients with acute pulmonary embolism . Results Blood gas analysis and D-dimer were the primary screening methods for PE. The positive rate of Pa O2 was 6 5.9%, that of Pa CO2 was 53.1%, and that of D-dimer was 70%. X-ray can be used as a suggestive basis, non-specific flake shadow appearance rate of 3.55%. ECG-specific changes (S Q T) incidence of only 3.8%, only as a reference for the PE. UCG can more clearly reflect the signs of PE increased right ventricular load, pulmonary artery diameter widened incidence of 75%; right ventricular enlargement 94.4%; pulmonary hypertension 64%; V / Q can be used as a more reliable means of emergency diagnosis of PE , The positive rate of 100%. Conclusions PE patients should be vigilant to emergency patients who have respiratory symptoms such as dyspnea, shortness of breath and so on. According to the above procedures, comprehensive examination can be performed to diagnose PE rapidly, accurately and practically