摘要
目的探讨肺栓塞溶栓及抗凝治疗后各个时期的血流恢复及血液动力学紊乱的改善程度。方法38例依据肺栓塞诊断的前瞻性研究(PIOPED)中肺灌注/通气扫描诊断标准确诊的肺栓塞患者,溶栓治疗28例,抗凝治疗10例。根据放射性分布缺损的肺段及放射稀疏程度相结合的半定量打分法对治疗前后进行评分。结果2组在治疗前缺损肺段计分差异无显著性(P>0.05),在治疗后7 d肺灌注缺损改善2组差异无显著性(P>0.05),30 d后差异有显著性(P<0.01),180 d时差异无显著性(P>0.05)。2组肺灌注缺损评分在治疗后7、30、180 d均较治疗前差异有显著性(P<0.01)。2组PaO2及PaCO2在治疗前差异无显著性(P>0.05),治疗后7、30、180 d均较治疗前差异有显著性(P<0.01)。结论肺灌注/通气扫描及血气分析可成为肺栓塞治疗后远期随访观察的最好监测手段。
Objective To diseuss recovery of blood flow and ameliorative degree of hemodynaraics disorder in each period after thrombolytie therapy and antieoagnlant therapy of pulmonary embolism. Methods There were 38 patients with pulmonary embolism diagnosed by standards of PIOPED pulmonary perfusion/ventilation scanning. Of them,28 patients were used by thrombolytic therapy and 10 patients by anticoagulant therapy. Score was judged by conditions before and after therapy through half-quantitation grading method according to radioactive distributed defective pulmonary segments combined with radioactive degree of rarefication. Results Before therapy, no significant difference between the two groups on to defective pulmonary segments （ P 〉0.05 ） ;after 7-days therapy,no significant difference between the two groups on pulmonary embolism defects improvement （ P 〉 0. 05 ） ; after 30 days, significant difference appears （ P 〈 0. 01 ） and no significant difference after 180 days （ P 〉0.05 ）. There were significant differences between the two groups through 7-day,30-day, and 180-day＇s therapy than before （ P 〈0. 01 ）. No significant difference between the two groups on PaO2 and PaCO2 before therapy （ P 〉 0. 05） ;and there were significant differences through 7-day,30-day and 180-day＇s therapy than before （P 〈 0, 01 ）. Conclusions Pulmonary perfusion/ventilation scanning and analysis on blood ＆ breath can be the best monitoring measure of long-term follow-up observation after pulmonary embolism therapy.
出处
《中国厂矿医学》
2006年第3期202-203,共2页
Chinese Medicine of Factory and Mine
关键词
肺栓寒
肺灌注/通气扫描
血气分析
随访
Pulmonary embolism
Pulmonary peffusion/ventilation scanning
Analysis on blood ＆ breath
Follow-up
