摘要
目的:探讨急诊肺动脉栓塞病人的诊断与治疗。方法:对65例确诊为肺栓塞的患者,分析其临床表现、心电图、胸部X线、血气及胸部计算机断层扫描结果,并总结治疗经验。结果:65例患者中以胸痛为主诉就诊者51例,以咯血为主诉者7例。血气分析PaO2<80 mmHg者65例;PaO2<60mmHg者49例。CT见血管栓塞者11例(91.7％)。心电图典型SI QⅢ TⅢ改变者13例(20％)。肺动脉压增高者45例(69.2％)。治疗上强调早期发现、早期溶栓,溶栓治疗效果不好或患者本身有禁忌症时,可选用介入治疗。结论:肺栓塞临床症状不典型,易误诊为冠心病、心绞痛及肺炎等多种疾病,诊断时应借助各种诊断手段,减少误诊率,及时治疗,减少并发症的发生。
Objective: Our Purpose was to discuss the diagnosis and treatment for patients with pulmonary embolism in emergency. Methods:Sixty-five patients with pulmonary embolism were included in this study. We analyzed the clinical manifestation, electrocardiogram, chest radiograph of X-ray, blood gas, and results of chest computerized tomography (CT)about chest. The treatment methods for these patients were also analyzed. Results:In these 65 patients,the chief complaint of 51 was chest pain and 7 was hemoptysis. The partid pressure of oxygen( PaO2) was less than 80 mmHg in 65 patients and less than 60 mmHg in 49 patients. By using CT,we found 11 patients had embolism in vessels. Thirteen patients (20% ) had typical changes on SI QIII TIII in electrocardiogram. Pulmonary pressure increased in 45 (69.2% ) patients. The early diagnosis and early thrombolytic therapy were important in the treatment for patients with pulmonary embolism. Intervene therapy may be introduced if the effect of thrombolytic therapy was not satisfactory or patients had contradication for thrombolytic therapy. Conclusion: The clinical symptoms of pulmonary embolism are not typical. Pulmonary embolism may be mis-diagnosed as coronary cardiopathy,angina pectoris,or pneumonia. We should use modern facilitations in diagnosis to reduce the mis-diagnosed rate. Early therapy should be performed to decrease complications.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2003年第2期167-168,共2页
Journal of China Medical University
