摘要
目的分析院内突发肺栓塞(pulmonary embolism,PE)患者临床特点,为提高PE的临床诊治水平提供依据。方法回顾性收集2011-01/2022-06月作者医院收治的427例PE患者的资料。依据PE发生时间将患者分为院内组(n=31)和院外组(n=396),院内组为因其它疾病入院在住院期间新发PE的患者,院外组为入院时已发生PE的患者。参照欧洲心脏病学会的PE危险程度分级将院内组患者分为高危组(n=7)和非高危组(n=24)。分析PE患者的临床表现,比较院内组和院外组、高危组和非高危组PE患者的临床资料差异。结果31例院内组PE患者,首发症状最常见的为心慌胸闷24例(77.42%),其次是气促19例(61.29%)、胸痛15例(48.39%)、咳嗽8例(25.81%)、晕厥4例(12.90%)。院内组PE患者肌钙蛋白T、肌酸激酶同工酶MB(creatine kinase isoenzyme MB,CK-MB)、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、气管插管比例、住院费用明显高于院外组(P均<0.05)。高危组患者晕厥比例、手术比例、乳酸、肌红蛋白、肌钙蛋白T、CK-MB、住院时长明显高于非高危组,pH明显低于非高危组(P均<0.05);院内组PE患者中,3例患者出现晕厥死亡,1例患者出现严重缺血缺氧性脑病,均来自高危组。结论院内突发PE严重威胁住院患者的生命,以晕厥作为首发症状,及乳酸、肌红蛋白、肌钙蛋白T、CK-MB高表达且住院时长增加对PE严重程度的判断有较大价值,为临床治疗提供了参考。
Objective To analyze the clinical characteristics of patients with sudden in-hospital pulmonary embolism(PE),thereby providing a basis for improving the clinical diagnosis and treatment of PE.Methods The data of 427 patients with PE admitted to the author′s hospital from January 2011 to June 2022 were retrospectively collected.Patients were divided into in-hospital group(n=31)and out-of-hospital group(n=396)based on the time of PE occurrence,the in-hospital group consisted of patients who developed new-onset PE during hospitalization for other diseases,while the out-of-hospital group included those with PE at the time of admission.The European society of cardiology′s risk stratification system was used to categorize the in-hospital group further into high-risk subgroup(n=7)and non-high-risk subgroup(n=24).The clinical manifestations of PE patients were analyzed,the differences in clinical data between the in-hospital and out-of-hospital groups,as well as between the high-risk and non-high-risk subgroups were compared.Results Of the 31 cases of PE patients in the in-hospital group,the most common initial symptom was palpitations and chest tightness in 24 cases(77.42%),followed by shortness of breath in 19 cases(61.29%),chest pain in 15 cases(48.39%),cough in 8 cases(25.81%),and syncope in 4 cases(12.90%).The levels of cardiac troponin T,creatine kinase isoenzyme MB(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),intubation proportions,and hospital costs were significantly higher in the in-hospital group than that in the out-of-hospital group(all P<0.05).Patients in the high-risk subgroup had significantly higher proportions of syncope and surgery,as well as higher levels of lactate,myoglobin,troponin T,CK-MB,and longer hospital stays compared with the non-high-risk subgroup,while pH was significantly lower than non-high-risk subgroup(all P<0.05);among the PE patients of the in-hospital group,3 cases experienced syncope leading to death,and one case developed severe ischemic hypoxic encephalopathy;al
作者
刘利波
李松林
邵素花
唐忠志
LIU Libo;LI Songlin;SHAO Suhua;TANG Zhongzhi(Department of Emergency Medicine,General Hospitaloy the Central Theater Command,Wuhan Hubei 430070,China)
出处
《联勤军事医学》
CAS
2024年第9期771-774,共4页
Military Medicine of Joint Logistics
关键词
院内突发肺栓塞患者
危险分层
首发症状
临床特征
Sudden in-hospital pulmonary embol-ism patients
Risk stratification
Initial symptom
Clinical characteristics
