摘要
目的探讨肺动脉高压(pulmonary arterial hypertension,PAH)合并矛盾性栓塞(paradoxical embolism,PDE)的诊断思路。方法回顾性总结2001年1月-2012年1月于北京中医药大学附属护国寺中医院住院并诊断PAH患者418例,根据多普勒超声心动图和(或)右心导管检查分为PAH不合并PDE组(350例)和PAH合并PDE组(68例),对比分析两组一般资料、病死率及医患矛盾投诉的差异,并计算PAH合并PDE患者首发表现的百分比。结果 PAH合并PDE组自身免疫病、慢性阻塞性肺病及肺栓塞病例高于不合并PDE组(P<0.05);PAH合并PDE组死亡病例高于不合并PDE组,且合并PDE组以脑卒中为首发表现的病例最多,占51.5%。结论肺动脉高压合并矛盾性栓塞易被临床忽视或缺少预见性,因其病死率较高且容易造成医患矛盾,应及早处理,对于合并不明原因的体循环动脉栓塞时应考虑到矛盾性栓塞可能。
Objective To investigate the diagnosis and treatment of pulmonary arterial hypertension （PAH） associated with paradoxical embolism （PDE）. Methods Clinical data about 418 patients admitted to Beijing University of Chinese Medicine Affiliated Huguosi Chinese Medicine Hospital were retrospectively summarized and the patients were divided into PAH not associated with PDE group （n=350） and PAH combined PDE group （n=68） according to the doppler echocardiography and/or right angiography. General data, the differences between mortality and the doctor-patient contradiction complaint were compared in two groups. Results The occurrence of autoimmune diseases, chronic obstructive pulmonary disease （COPD）, pulmonary embolism and dead cases in PAH combined PDE group were significantly higher than that in PAH not associated with PDE group （P 〈 0.05）. Conclusion PAH combined PDE are easily ignored by clinical treatment and lacking of foresight, paradoxical embolism should be taken into consideration when systemic arterial embolism with unknown causes appears.
出处
《解放军医学院学报》
CAS
2014年第10期1031-1033,共3页
Academic Journal of Chinese PLA Medical School
关键词
肺动脉高压
卵圆孔
肺栓塞
矛盾性栓塞
脑卒中
pulmonary arterial hypertension
ovale foramen
pulmonary embolism
paradoxical embolism
stroke
