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目的研究探讨慢性阻塞性肺疾病急性加重期(AECOPD)并肺栓塞(PE)的临床特点,以提高临床诊治成功率。方法 24例AECOPD并PE患者,研究分析其临床表现、体征、实验室检查、治疗转归结果。结果呼吸困难、胸痛、咯血等是AECOPD并肺栓塞常见临床症状,体征常见窦性心动过速、下肢不对称性肿胀;实验室检查结果显示动脉血二氧化碳分压(Pa CO2)下降或呈Ⅰ型呼吸衰竭表现;D-二聚体>0.5 mg/L患者占54.17%,75.00%患者超声心动图检查显示伴肺动脉高压。经过临床治疗后治愈21例,死亡3例,病死率12.50%。结论慢性阻塞性肺疾病急性加重期并肺栓塞临床表现不典型,误诊率高,病死率高,应根据临床特点提高鉴别诊断能力,提高患者生存率。
Objective To study the clinical features of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and pulmonary embolism (PE) in order to improve the success rate of clinical diagnosis and treatment. Methods Twenty - four patients with AECOPD and PE were studied for clinical manifestations, signs, laboratory tests and outcome of treatment. Results Dyspnea, chest pain and hemoptysis were common clinical symptoms of AECOPD and pulmonary embolism. Common signs of sinus tachycardia and asymmetry of lower extremities were swollen. The results of laboratory tests showed that arterial carbon dioxide (PaCO 2) decreased or showed type Ⅰ Respiratory failure performance; D-dimer> 0.5 mg / L patients accounted for 54.17%, 75.00% of patients with echocardiography showed pulmonary hypertension. After clinical treatment, 21 cases were cured, 3 died, the fatality rate was 12.50%. Conclusion The clinical manifestations of acute exacerbation of chronic obstructive pulmonary disease and pulmonary embolism are not typical, the rate of misdiagnosis is high and the case fatality rate is high. Therefore, the differential diagnosis ability should be improved according to the clinical features to improve the survival rate of patients.