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目的:分析肺血栓栓塞症的基础疾病、临床表现、辅助检查,提高对肺血栓栓塞症认识,减少误诊率。方法:回顾性分析100例肺血栓栓塞症患者的临床资料。结果:90%的患者存在高危因素,其中下肢深静脉血栓形成占37%,外科手术占24%。常见临床表现为呼吸困难、胸痛及咳嗽;D-二聚体阳性率100%;血气分析异常78%,心电图变化82%,超声心动图异常82%,下肢B超及下肢深静脉造影异常63%。CT肺动脉造影结果异常80%,为早期诊断提供依据。10例行溶栓加抗凝治疗,有效率100%,70例行抗凝治疗,有效率95.7%,20例于患病后立即死亡。结论:肺血栓栓塞症与基础疾病密切相关,临床表现多样,采用多种诊断手段与临床表现相结合可提高诊断率,减少误诊率。
Objective: To analyze the basic diseases, clinical manifestations, auxiliary examinations of pulmonary thromboembolism, raise awareness of pulmonary thromboembolism and reduce the misdiagnosis rate. Methods: The clinical data of 100 patients with pulmonary thromboembolism were retrospectively analyzed. RESULTS: Ninety percent of patients had high-risk factors, including 37% of deep venous thrombosis of lower extremities and 24% of surgery. Common clinical manifestations of dyspnea, chest pain and cough; D-dimer positive rate of 100%; 78% abnormal blood gas analysis, ECG changes 82%, 82% of echocardiographic abnormalities, lower extremity B and deep venous angiography 63% . CT pulmonary angiography results abnormal 80%, provide the basis for early diagnosis. 10 cases of thrombolysis and anticoagulation therapy, the effective rate of 100%, 70 cases of anticoagulant therapy, the effective rate was 95.7%, 20 patients died immediately after the illness. Conclusion: Pulmonary thromboembolism is closely related to underlying diseases, with various clinical manifestations. The combination of various diagnostic methods and clinical manifestations can improve the diagnostic rate and reduce the misdiagnosis rate.