摘要
为提高对肺栓塞临床实验室所见的认识和其诊断水平，回顾性分析７２例慢性栓塞性肺动脉高压的临床资料，列举和分析了常见症状、体征及实验室检查。结果显示，动脉血氧分压（ＰａＯ２）、动脉血二氧化碳分压（ＰａＣＯ２）减低，肺泡气－动脉血氧分压差（Ｐ（Ａ－ａ）Ｏ２）增大，Ｘ线胸片示肺血不匀和心电图右室肥厚分别占８０．３％和７６．４％，超声心动图示右房、右室内径扩大分别占９２．５％和９７．１％，有心包积液者１１．１％，有肺动脉压增高者为１００．０％。右心导管测肺动脉平均压为６．５０±１．８０ｋＰａ（４８．７５±１３．５０ｍｍＨｇ），肺动脉造影有阳性所见者占９３．８％，放射性核素肺灌注扫描阳性者为１００．０％。有下肢深静脉病史者４３．１％，核素造影阳性者占７５．０％。院外误诊率高达９０．３％。结果表明，了解栓塞性肺动脉高压的临床表现和实验室所见，对提高本病的诊断意识和水平是重要的。
To improve the identification of chronic thromboembolic pulmonary hypertension. We restrospectively analysed clinical data of 72 patients with chronic thromboembolic pulmonary hypertension (CTEPH). The levels of arterial blood gases appeared to be decrease in PaO 2 and PaCO 2, and increase in P (A-a) O 2. There were 80.3% of unsymmetrical pulmonary hyperlucencies on chest radiograph and 76.4% of right ventricular hypertrophy on electrocardiograph, 92.5% and 97.1% of right atrial and right ventricular enlargement, respectively. 11.1% of pericardial effusion was noted on echocardiograph, and 98.5% of rise in pulmonary arterial pressure calculated by Doppler. The mean pulmonary arterial pressure was 6.50 ±1 80kPa (48.75±13 50mmHg), in part, by right cardiac catheterazation. Both the incidences of pulmonary embolism were 100.0% on pulmonary angiography and on radionuclide lung perfusion scan. There were 43.1% of the history of deep venous disorders and 75.0% of the positive findings by radionuclide venography in the lower extremities, respectively. The misdiagnostic and the lost diagnosis rate of prehospitalization accounted for 90.3%. The understanding of clinical manifestations and laboratory findings of CTEPH is important to promote diagnostic sense and level of CTEPH.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1997年第5期321-324,共4页
Chinese Journal of Internal Medicine
