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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 ,提高诊治水平
Objective To improve the diagnosis and treatment of acute pulmonary embolism (APE). Methods The clinical data of 10 patients diagnosed as APE were analyzed. Results The average age of 10 APE patients in this group was 4 7.4 years old. Common symptoms are unexplained labored dyspnea (100%), chest pain (60%), hemoptysis (30%), pulmonary infarction triad (20%), shock and syncope (1%). Important signs: 9 cases of accelerated respiratory heart rate, jugular vein filling in 1 case, lower extremity asymmetric swelling and pain in 8 cases. Laboratory tests showed varying degrees of arterial blood gas abnormalities (hypoxemia, hypocapnia), high plasma fibrinogen; non-specific transient ECG changes. Echocardiography and spiral CT, respectively, can be used as a screening and diagnostic tools, and can be used for efficacy evaluation. All 10 patients were discharged after treatment, of which 5 patients received intravenous thrombolysis, and 1 patient underwent vena cava filter implantation to prevent recurrence of PE. Conclusions Pulmonary embolism is frequently-occurring disease. To master the common symptoms and signs of pulmonary embolism, some laboratory tests and epidemiology will reduce the misdiagnosis and missed diagnosis of pulmonary embolism and improve the diagnosis and treatment