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反复发生肺栓塞最终将导致呼吸功能不全、严重的低氧血症和进行性肺高压。许多病例在初期并无任何征象,但一旦发生血栓性静脉炎时,抗凝治疗就会失效,除非进行栓子摘除术,否则大部分病例将因严重的呼吸功能不全而死亡。在Duke大学医学中心,1968～1983年共收治25例,其中14例为缓解其严重的呼吸功能不全而作择期性肺动脉栓子切除术。男性9例,女性5例。年龄20～55岁。所有病例均曾接受过长期华法令(Warfarin) 抗凝治疗。术前症状持续平均达4.8年。其主要症状:运动性呼吸困难占86%,血栓性静脉炎79%,进行性呼吸困难64%,咳血50%,胸痛26%,疲乏21%。主要体征:肺动
Recurrent pulmonary embolism will eventually lead to respiratory insufficiency, severe hypoxemia and progressive pulmonary hypertension. Many cases do not have any signs of early onset, but anticoagulant therapy fails in the event of thrombophlebitis and most cases will die of severe respiratory insufficiency unless an embolectomy is performed. At Duke University Medical Center, 25 patients were treated in 1968-1983, of whom 14 underwent elective pulmonary embolectomy to relieve their severe respiratory insufficiency. 9 males and 5 females. Age 20 ~ 55 years old. All patients received long-term warfarin anticoagulation. Preoperative symptoms continued for an average of 4.8 years. The main symptoms: exercise-induced dyspnea 86%, 79% of thrombophlebitis, progressive dyspnea 64%, hemoptysis 50%, 26% of chest pain, fatigue 21%. The main signs: Pulmonary motility