论文部分内容阅读
目的探讨肺癌合并肺栓塞(PE)的临床特点及预后,指导今后的临床工作。方法回顾性分析2005年10月~2013年10月本院呼吸科21例肺癌合并PE患者的临床资料,另选21例单纯肺癌患者做临床对照。结果与单纯肺癌组比较,肺癌合并PE组呼吸困难、发绀、晕厥、下肢不对称性水肿等症状的发生率明显升高,有统计学差异(P<0.05)。而咳嗽、咳痰、咯血、胸痛等症状无统计学差异。超声心动图提示肺癌合并PE组肺动脉压(PAP)明显升高,血BNP及D-二聚体明显升高,与单纯肺癌组比较,有统计学差异(P<0.05)。结论肺癌合并PE患者的症状常不典型,当肺癌患者有静脉留置管化疗、放疗、手术、长期卧床等危险因素,出现突发性呼吸困难或原有的呼吸困难加重、晕厥、发绀、下肢不对称性水肿等症状,结合PAP、BNP及D-二聚体明显升高时要考虑肺栓塞的可能,尽快完善CT肺动脉造影(CTPA)确诊,及时给予有效的治疗,有效率95.2%,预后多较好。
Objective To investigate the clinical characteristics and prognosis of lung cancer complicated with pulmonary embolism (PE) and to guide future clinical work. Methods The clinical data of 21 patients with lung cancer with PE treated in our hospital from October 2005 to October 2013 were retrospectively analyzed. Another 21 patients with lung cancer were selected as the clinical control. Results Compared with simple lung cancer group, the incidence of dyspnea, cyanosis, fainting and asymmetric edema of lower extremity in lung cancer patients with PE were significantly higher (P <0.05). The cough, sputum, hemoptysis, chest pain and other symptoms no statistical difference. Echocardiography showed pulmonary hypertension (PAP) in patients with lung cancer combined with PE significantly increased, blood BNP and D-dimer increased significantly, compared with simple lung cancer group, there was a significant difference (P <0.05). Conclusions The symptoms of patients with lung cancer complicated with PE are often not typical. When patients with lung cancer have risk factors such as chemotherapy, radiotherapy, surgery, long-term bed rest and so on, they have sudden dyspnea or aggravating dyspnea, syncope, cyanosis, Symmetric edema and other symptoms, combined with PAP, BNP and D-dimer significantly increased to consider the possibility of pulmonary embolism, as soon as possible to improve CT pulmonary angiography (CTPA) diagnosis, timely and effective treatment, effective rate was 95.2%, prognosis and more better.