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目的 回顾性分析急性肺栓塞的临床及实验室检查特点 ,旨在早期诊断。方法 对无心肺基础疾病的以呼吸困难为主的、经高速螺旋CT及三维重建检查而诊断的 15例肺栓塞患者 ,对其临床及其他实验室检查进行回顾性分析。结果 突出的临床表现为呼吸困难、胸闷心悸 ;体症为呼吸急促、收缩期杂音、及心动过速。实验室检查主要是彩色多普勒超声心动图检查 ,部分病例在肺动脉内见到栓子 ,全部病例可见三尖瓣返流以及由此估测的肺动脉收缩压 ,肺动脉收缩压均高于正常 (4 2～ 76mmHg) ;血气分析显示PaO2 明显下降 (3 0～ 65mmHg)。结论 对突发的以呼吸困难、心悸等为主患者 ,在无高速螺旋CT设备时 ,彩色多普勒为首选检查方法 ,可根据其肺动脉压力的增高、右室扩大以及肺动脉的脉冲频谱特点作出明确的诊断而得到及时的治疗
Objective To retrospectively analyze the clinical and laboratory features of acute pulmonary embolism with the purpose of early diagnosis. Methods Fifteen patients with pulmonary embolism diagnosed by high-speed spiral CT and three-dimensional reconstructive imaging, who were mainly with dyspnea without cardiopulmonary basic diseases, were retrospectively analyzed in their clinical and other laboratory tests. The results of outstanding clinical manifestations of dyspnea, chest tightness palpitations; physical symptoms of shortness of breath, systolic murmur, and tachycardia. Laboratory tests were mainly color Doppler echocardiography, some cases of emboli seen in the pulmonary artery, all cases showed tricuspid regurgitation and pulmonary artery systolic blood pressure estimated therefrom, pulmonary artery systolic blood pressure were higher than normal ( 4 2 ~ 76mmHg); blood gas analysis showed PaO2 decreased significantly (30 ~ 65mmHg). Conclusions Color Doppler is the first choice for the sudden onset of dyspnea and palpitations in patients without high-speed spiral computed tomography (CT), which can be made according to the increase of pulmonary artery pressure, the enlargement of the right ventricle and the pulse spectrum of the pulmonary artery A clear diagnosis and timely treatment