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目的了解肺血栓栓塞症(PTE)临床特点,提高PTE的诊断率。方法2004年11月至2007年5月对66例临床可疑PTE患者进行CT肺动脉造影检查,并根据检查结果分为PTE组和非PTE组,分析比较两组临床特点。结果31例(47.0%)确诊为PTE(PTE组),35例(53.0%)无PTE(非PTE组)。PTE组呼吸困难(92.9%)、呼吸增快(64.5%)均高于非PTE组(66.7%和31.4%)。PTE组非对称性下肢肿胀(38.7%,12/31)显著高于非PTE组(5.7%,2/35)。PTE组下肢静脉血栓形成阳性率(60.9%)高于非PTE组(17.9%)。PTE组低氧血症(92.6%)、低碳酸血症(51.9%)和低氧血症合并低碳酸血症(48.1%)发生率也均高于非PTE组(69.7%、18.2%,和18.2%)。血浆D-二聚体阳性率两组无差异性(87.5%对74.1%)。结论呼吸困难、双下肢非对称性肿胀、低氧血症和低碳酸血症是诊断PTE的重要线索,同时具备这些临床表现者应尽快完善PTE的相关检查。
Objective To understand the clinical features of pulmonary thromboembolism (PTE) and improve the diagnostic rate of PTE. Methods From November 2004 to May 2007, CT pulmonary angiography was performed in 66 patients with suspected PTE and divided into PTE group and non-PTE group according to the examination results. The clinical features of the two groups were analyzed and compared. Results 31 cases (47.0%) were diagnosed as PTE (PTE group) and 35 cases (53.0%) had no PTE (non-PTE group). Dyspnea (92.9%) and increased respiration (64.5%) were higher in the PTE group than in the non-PTE group (66.7% vs 31.4%). Asymmetric lower extremity swelling in the PTE group (38.7%, 12/31) was significantly higher than in the non-PTE group (5.7%, 2/35). The positive rate of lower extremity venous thrombosis in PTE group (60.9%) was higher than that in non-PTE group (17.9%). The incidences of hypoxemia (92.6%), hypocapnia (51.9%) and hypoxemia with hypocapnia (48.1%) in PTE group were also higher than those in non-PTE group (69.7%, 18.2%, and 18.2%). Plasma D-dimer positive rate was no difference between the two groups (87.5% vs. 74.1%). Conclusions Dyspnea, asymmetric swelling of the lower extremities, hypoxemia and hypocapnia are important clues in the diagnosis of PTE. Patients with these clinical manifestations should complete the relevant PTE examination as soon as possible.