摘要
目的提高肺栓塞临床诊断治疗的正确率.方法对我院1988年～2004年确诊的资料完整的26例肺栓塞病例进行临床分析.结果24例存活,2例死亡.12例合并下肢深静脉血栓形成者,其中6例行下腔静脉滤器置入术,术后长期口服华法令抗凝治疗,病情稳定;6例未行滤器置入术者2例死亡,2例口服华法令期间反复出现大咯血,2例抗凝治疗病情稳定.14例未合并下肢深静脉血栓形成者经溶栓+肝素和华法令抗凝或单纯抗凝治疗后病情缓解稳定.结论对于临床高度怀疑肺栓塞的病人,X线胸片、心电图、动脉血气分析、D-二聚体可作为筛选检查,结合肺通气灌注显像、胸部CT、MR、下肢深静脉及肺动脉造影可确诊.溶栓和抗凝治疗可有效缓解病情,有下肢深静脉巨大或可漂移血栓者行下腔静脉滤器置入术短期内可有效预防新的肺栓塞.
<abstract>jective To improve the correct diagnosis and treatment of pulmonary embolism(PE) . Methods Clinical data from 26 patients in Guangdong Provincial People's Hospital who suffered pulmonary embolism between 1988 and 2004 were analyzed together. Results 24 cases survived and 2 cases died. Of which the 12 cases who had deep venous thrombus (DVT), 6 cases , who inserted intraluminal filter in the inferior vena cava to prevent new pulmonary embolism followed by anticoagulation thrapy resulted in good condition. The other 6 cases who did not insert filters resulted in death in 2, great hemoptysis in 2 and stable condition in 2. Besides, the 14 cases without DVT underwent thrombolysis followed by anticoagulation with heparin and warfarine or anticoagulation only .All of the 14 cases resulted in stable condition. Conclusions To the clinical patients who are doubted PE, chest radiogram , EKG , ABG and D-dimer can be used as the screening test, ventilation/perfusion lung scan , CT , MR and pulmonary or extremity venous angiography are to make the diagnosis of pulmonary embolism accurately. Thrombolysis and anticoagulation therapy can remit PE effectively, patients with great or floating DVT inserted with filter in the inferior vena cava can prevent new PE effectively in the near future.
出处
《国际医药卫生导报》
2004年第16期8-10,共3页
International Medicine and Health Guidance News
关键词
肺栓塞
深静脉血栓
滤器
<keyword>lmonary embolism Deep venous thrombus Filter
