摘要
目的 提高急性肺动脉栓塞 (APE)的诊治水平。方法 对 10例确诊为 APE病人的临床资料进行分析。结果 本组 10例 APE患者平均年龄 4 7.4岁。常见的症状为原因不明的劳力性呼吸困难 (10 0 % )、胸痛 (6 0 % )、咯血 (30 % )、肺梗死三联征 (2 0 % ) ;休克、晕厥 (1% )。重要体征 :呼吸心跳频率加快 9例 ,颈静脉充盈 1例 ,下肢不对称肿痛 8例。实验室检查示有不同程度动脉血气异常 (低氧、低碳酸血症 ) ,高血浆纤维蛋白血症 ;非特异性一过性心电图改变。超声心动图及螺旋 CT分别可作为筛选及确诊手段 ,并可用于疗效评价。 10例患者治疗后均好转出院 ,其中 5例患者接受静脉溶栓治疗 ,1例患者行腔静脉滤器植入术预防 PE再发。结论 肺栓塞是多发病 ,掌握肺栓塞的常见症状、体征 ,部分实验室检查及流行病学将减少肺栓塞的误诊和漏诊 。
Objective To improve the diagnosis and therapy of acute pulmonary embolism(APE).Methods clinical data of 10 patients with APE were analyzed.Results 10 patients were an average of 47 4 years old.The commonly clinical manifestations included dyspna during exercises(100%),chest pain(60%),hemoptysis(30%),symptoms of all above determined as pulmonary infarction(20%) and shock or fainting(10%),shortness of breath and fast heart beats(9/10),jugular conestion(1/10)and non symmetric swell and tenderness in lower extremity(8/10) account for helpful signs.Abnormal arterial blood gas,high level of fibrinogenemia,together with the changes in ECG.Echocardiogram and spiral CT were applied to diagnosis of APE and evaluation of therapeutie effieacy.Among all cases,5 patients were treated with thrombolysis and anticogalation therapy,1 with vena caval filter in the prevention of pulmonary embolism.Conclusion Diagnosis of APE mainly depends on patients clinical symptoms and signs,as well as labortatory profiles and epidemiology,early diagnosis and therapy will improve its prognosis.
出处
《福建医药杂志》
CAS
2002年第6期14-16,共3页
Fujian Medical Journal
