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目的提高对肺栓塞诊疗的认识,减低肺栓塞漏、误诊率。方法回顾性分析54例肺栓塞患者临床表现、实验室检查、螺旋CT、肺核素影像等临床资料。结果易发肺栓塞的因素为下肢深静脉血栓、原发心肺疾病、恶性肿瘤、外科手术及创伤、长期卧床>1周者,在诊断过程中,D-二聚体测定可做为筛查疑似肺栓塞的高度敏感但非特异的方法,治疗时积极溶栓、抗凝治疗可降低病死率,肝素与华法林重叠3~5d有绝对的必要性。结论临床医师只要对疑似肺栓塞病例有高度警惕性,规范化诊断治疗,可明显改善其预后。
Objective To improve the diagnosis and treatment of pulmonary embolism, reduce pulmonary embolism leakage, misdiagnosis rate. Methods Retrospective analysis of 54 cases of pulmonary embolism clinical manifestations, laboratory tests, spiral CT, pulmonary radionuclide imaging and other clinical data. Results The most common causes of pulmonary embolism were deep venous thrombosis of the lower extremities, primary cardiopulmonary diseases, malignant neoplasms, surgery and trauma, and bed rest for more than 1 week. During the diagnosis, D-dimer assay could be used as screening screening A highly sensitive but nonspecific approach to pulmonary embolism, with aggressive thrombolysis during treatment and anticoagulant therapy to reduce mortality, there is an absolute need for overlapping heparin and warfarin 3 to 5 days. Conclusion As long as the clinicians have a high degree of vigilance on suspected cases of pulmonary embolism, standardized diagnosis and treatment can significantly improve their prognosis.