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目的加深对肺血栓栓塞症所致肺损害的认识,进而提高诊断意识。方法对确诊的26例肺血栓栓塞症病例临床资料进行回顾性分析。结果肺血栓栓塞症缺乏临床特异性,易漏诊、误诊;血气分析有呼吸衰竭者占29.9%,D-dimer大于500μg/dl者占96.2%;UCG呈典型改变者占46.2%,CTPA示肺动脉内有大小面积不等的充盈缺损占100%;放射性核素扫描提示至少一个肺段灌注缺损并与通气不匹配者占23.1%。结论肺血栓栓塞症所致肺损害较常见,CTPA和核素肺通气/灌注显像可作为PTE确诊的一线检查手段。早期抗凝和溶栓治疗可提高此类患者生存率。
Objective To deepen the understanding of lung damage caused by pulmonary thromboembolism and further improve the diagnostic consciousness. Methods The clinical data of 26 confirmed pulmonary thromboembolism cases were retrospectively analyzed. Results Pulmonary thromboembolism was not clinically specific and was easily misdiagnosed. Blood gas analysis had respiratory failure (29.9%), D-dimer was more than 500μg / dl (96.2%), UCG (46.2%), CTPA showed pulmonary artery Filling defects of varying sizes accounted for 100% of the total; radionuclide scans prompted at least one pulmonary perfusion defect and did not match ventilation, accounting for 23.1%. Conclusions Lung damage caused by pulmonary thromboembolism is more common. CTPA and radionuclide pulmonary ventilation / perfusion imaging can be used as the first line of diagnosis for PTE. Early anticoagulation and thrombolytic therapy can improve the survival rate of such patients.