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目的提高骨科患者围手术期内肺栓塞诊治的再认识。方法回顾分析14例骨科患者围手术期内肺栓塞诊断流程和治疗结果,并行疗效评定。结果14例中未经治疗死亡3例,接受治疗11例(占78.6%),全部病例均常规行抗凝、溶栓治疗。其中经皮导管介入治疗肺动脉溶栓术6例,下腔静脉滤网植入术5例。治愈或好转9例(占81.8%),无效死亡2例(占18.2%)。死亡病例均经尸检证实。结论必须加强提高对围手术期内肺栓塞的再认识,对围手术期内高度怀疑的肺栓塞,宜“宁信其有,勿信其无”。预防是防治围手术期内肺栓塞的最好办法。内、外科联合采取综合治疗的方法可取得满意疗效。
Objective To improve the understanding of diagnosis and treatment of pulmonary embolism during perioperative period in orthopedic patients. Methods Retrospective analysis of 14 cases of orthopedic patients during the perioperative pulmonary embolism diagnosis process and treatment results, parallel curative effect evaluation. Results Of the 14 patients, 3 died without treatment and 11 received treatment (78.6%). All the patients were treated with anticoagulation and thrombolysis routinely. Including percutaneous catheter interventional pulmonary artery thrombolysis in 6 cases, inferior vena cava filter implantation in 5 cases. 9 cases were cured or improved (81.8%), 2 cases were ineffective (18.2%). Deaths were confirmed by autopsy. Conclusions It is necessary to enhance the re-understanding of pulmonary embolism during perioperative period. For pulmonary embolism, which is highly suspected during perioperative period, it is advisable to “believe it and not to believe it.” Prevention is the best way to prevent perioperative pulmonary embolism. Internal and surgical combination of comprehensive treatment methods can be obtained satisfactory results.