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目的 探讨急诊诊断的急性肺栓塞病人的临床、实验室和辅助检查特点及治疗措施。方法 对胸痛中心成立半年诊断和治疗的 13例肺栓塞病人的资料进行总结和评估。结果 本组病人肺栓塞发病率在 70~ 80岁最高 ,最常见的危险因素为下肢深静脉血栓 ,占 30 8% ,最常见的临床症状是不明原因的呼吸困难 ,占 6 9 2 % ;血气分析有低氧血症者占 84 6 % ;D 二聚体 >5 0 0 μg/dl者占 5 0 % ;心电图出现SⅠQⅢTⅢ 者占 6 1 5 % ;超声心动图和核素肺通气灌注扫描存在典型改变者分别占72 7%和 87 5 %。结论 临床特点、实验室和特殊检查资料的结合可提高急诊诊断肺栓塞的阳性率 ;超声心动图是血流动力学不稳定的大块肺栓塞病人首选检查手段 ;根据病情选择恰当的治疗方案疗效显著
Objective To explore the clinical, laboratory and auxiliary examination features and treatment of acute pulmonary embolism in emergency diagnosis. Methods Thirteen patients with pulmonary embolism diagnosed and treated for half a year at the center of chest pain were summarized and evaluated. Results The incidence of pulmonary embolism in this group was the highest at 70 to 80 years old. The most common risk factor was deep venous thrombosis of lower extremities, accounting for 30.8%. The most common clinical symptoms were unexplained dyspnea, accounting for 69.2%. Blood gas Analysis of hypoxemia accounted for 84 6%; D dimer> 500 μg / dl accounted for 50%; electrocardiogram SⅠQⅢTⅢ accounted for 61.5%; echocardiography and radionuclide pulmonary perfusion scan Typical changes accounted for 72.7% and 87.5% respectively. Conclusion The combination of clinical features, laboratory and special examination data can increase the positive rate of emergency diagnosis of pulmonary embolism. Echocardiography is the first choice of examination in patients with unstable hemodynamics pulmonary embolism. According to the condition, the appropriate treatment is selected Significant