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目的利用99mTc-大颗粒聚合白蛋白(MAA)肺灌注显像(PPI)监测肺下肢创伤及手术后(LEPP)肺栓塞(PE)患者的疗效。方法19例临床确诊的LEPP合并PE患者分别于溶栓治疗前、治疗2～4周后进行PPI;PPI图像上显示一个肺段灌注完全缺损记3分,缺损25%～75%记2分,<25%记1分,无异常记0分,根据记分变化分析溶栓治疗前后临床改善情况。结果19例患者溶栓治疗2～4周后临床症状完全消失10例、明显改善6例、有改善3例,治疗前(10.2±3.8)后(2.8±1.4)PPI记分差异有统计学意义(t=7.75,P<0.01)。结论PPI为一种准确、可靠的无创性评价肺血流改善的手段,对LEPP合并PE患者疗效观察具有重要的临床价值。
Objective To evaluate the efficacy of 99mTc-MAA pulmonary perfusion imaging (PPI) in detecting pulmonary embolism (PE) in patients with pulmonary lower extremity trauma and postoperative (LEPP). Methods Nineteen patients with clinically diagnosed LEPP complicated with PE before PPT were treated with PPI 2 to 4 weeks after the thrombolytic therapy. One PPI showed 3 segments of complete lung perfusion defect and 2 points of 25% -75% <25% recorded 1 point, no abnormal record 0 points, according to score changes before and after thrombolytic therapy clinical improvement. Results In 19 patients, the clinical symptoms completely disappeared after 2 to 4 weeks of thrombolysis in 10 cases, 6 cases improved obviously, 3 cases improved, and the PPI score was significantly different between before and after (10.2 ± 3.8) (10.2 ± 1.4) t = 7.75, P <0.01). Conclusion PPI is an accurate and reliable noninvasive means to evaluate the improvement of pulmonary blood flow and has important clinical value in the observation of the therapeutic effect of LEPP combined with PE.