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目的总结肺栓塞临床表现与诊疗体会,提高对肺栓塞的认识,减少临床漏诊及误诊率。方法回顾性分析21例肺栓塞患者的临床表现,诊断及治疗方法比较。结果 21例患者中1例临床诊断,20例由CT肺动脉造影(CT-PA)确诊。其中7例接受溶栓+抗凝治疗,13例仅接受抗凝治疗,两组治疗有效率差异无统计学意义(P>0.05)。结论肺栓塞的临床表现缺乏特异性,D-二聚体阴性可以基本除外急性肺栓塞,CT肺动脉造影(CTPA)是首选的确诊手段。提高对PE患者的诊断意识,及时有效的规范化治疗,是临床提高PE患者救治成功率的关键。
Objective To summarize the clinical manifestation, diagnosis and treatment of pulmonary embolism, improve the understanding of pulmonary embolism and reduce the rate of clinical misdiagnosis and misdiagnosis. Methods The clinical manifestations, diagnosis and treatment of 21 patients with pulmonary embolism were retrospectively analyzed. Results Of the 21 patients, 1 was diagnosed clinically and 20 was diagnosed by CT pulmonary angiography (CT-PA). Among them, 7 received thrombolytic therapy and anticoagulant therapy, while 13 received anticoagulation therapy only. There was no significant difference in the two groups (P> 0.05). Conclusions The clinical manifestations of pulmonary embolism are lack of specificity. D-dimer can be excluded except for acute pulmonary embolism. CT pulmonary angiography (CTPA) is the first choice of diagnosis. To improve the diagnosis of PE patients awareness, timely and effective standardization of treatment is clinically the key to improving the success rate of treatment of PE patients.