摘要
目的探讨手术后肺栓塞（pulmonary embolism，PE）的临床特点与诊疗策略。方法回顾性分析2001年1月至2010年12月51例术后PE病例的临床表现、诊治情况及转归等资料。结果术后PE骨科患者占25．50％（13／51），恶性肿瘤患者占45．10％（23／51）。术后1周内发病者占70．59％（36／51），其中术后第2天发病人数最多（13／51，26．92％）。最常见主诉为呼吸困难、胸闷或憋气（34／51，66．67％），术后猝死也是PE的常见发病形式（18／51，35．29％）。多数病例存在术前对PE危险因素评估不足，而术后出现可疑高危PE时，对床旁超声心动图的应用价值认识不足。本组术后PE的治疗仍以抗凝为主（23例，占治疗病例的79．31％），静脉溶栓3例，导管介入治疗3例。结论PE是外科患者术后死亡的常见原因，加强防治非常重要。
Objective To evaluate the diagnosis and treatment of postoperative pulmonary embolism（PE）. Methods We retrospectively analyzed clinical manifestations, diagnosis, treatment and prognosis of 51 postoperative PE. Results 36 PE （70. 59% ） developed after orthopaedic surgery or with malignant tumors within 1 week after surgery. Dyspnea or chest distress was the most common symptoms. Sudden death was common in patients with PE. Problems in diagnosis of PE included： poor assessment of deep vein thrombosis（DVT） before operation, and the value of beside echocardiography in the diagnosis of patients with suspected high-risk PE was not fully recognized. Twenty-three PE cases received only anticogulant treatment. Intravenous thrombolysis or percutaneous interventional techniques were undertaken in 3 each cases. Cardiopulmonary resuscitation（CPR） simply after sudden death due to postoperative PE was often unsuccessful. Conclusions Postoperative PE is a common cause of death, currently available measures are often ineffective. The key lies in prevention especially in those of high-risk PE or suspected non-high-risk PE.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第4期299-301,共3页
Chinese Journal of General Surgery
关键词
肺栓塞
手术后并发症
Pulmonary embolism
Postoperative complications
