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目的分析影响急性肺栓塞(APE)患者远期预后的危险因素。方法回顾134例APE患者的临床及随访资料。依据APE患者随访远期预后结果(预后良好/预后不良)将入选患者分为良好组97例与不良组37例。分析影响急性肺栓塞患者远期预后的危险因素。结果年龄、恶性肿瘤、心房纤颤、右心功能不全、休克/低血压、院外抗凝治疗情况、BNP、cTnl、PaO_2、D-二聚体、PT等指标对APE患者远期预后有影响。而年龄、恶性肿瘤、右心功能不全及院外抗凝治疗差为影响APE远期预后的独立危险因素。结论 APE院外治疗应保证维持有效抗凝,同时重视基础疾病的控制,对存在右心功能不全者须积极改善心功能,而对恶性肿瘤患者需综合考虑。
Objective To analyze the risk factors affecting the long-term prognosis of patients with acute pulmonary embolism (APE). Methods The clinical and follow-up data of 134 APE patients were reviewed. The patients were divided into 97 cases of good group and 37 cases of poor group according to the long-term prognosis of APE patients (good prognosis / poor prognosis). To analyze the risk factors affecting the long-term prognosis of patients with acute pulmonary embolism. Results Age, malignancy, atrial fibrillation, right ventricular dysfunction, shock / hypotension, anticoagulant therapy in hospital, BNP, cTnl, PaO_2, D-dimer and PT all had long-term prognosis in patients with APE. Age, malignancy, right ventricular dysfunction and poor anticoagulant therapy are independent risk factors for long-term prognosis of APE. Conclusions APE should ensure effective anticoagulation while maintaining effective anticoagulation. At the same time, emphasis should be placed on the control of underlying diseases. In patients with right ventricular dysfunction, heart function must be improved actively, while patients with malignant tumors should be considered comprehensively.