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目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并肺血栓栓塞症(PTE)的临床特点。方法选取AECOPD合并PTE病例36例,对其临床资料进行回顾性研究。结果慢性阻塞性肺病急性加重期合并PTE临床症状无明显特异性,主要症状包括呼吸困难、胸痛、咯血、晕厥等。高危因素主要为:6周内外伤史、6周内手术史、长期卧床(≥7 d)。全部患者经内科保守治疗,有效率97.2%,病死率2.8%。结论当AECOPD患者出现无法解释的呼吸困难时,及合并有静脉血栓史、6周内手术史、长期卧床(≥7 d)的危险因素时,应采用CTPA、MRPA、螺旋CT血管成像、D-二聚体和双下肢静脉超声等查检明确诊断,尽早治疗。
Objective To investigate the clinical features of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary thromboembolism (PTE). Methods AECOPD combined with PTE in 36 cases, the clinical data were retrospectively studied. Results There was no significant difference in the clinical symptoms of PTE with acute exacerbation of chronic obstructive pulmonary disease. The main symptoms were dyspnea, chest pain, hemoptysis and syncope. The main risk factors are: history of trauma within 6 weeks, history of surgery within 6 weeks, bedridden (≥7 d). All patients received conservative medical treatment, the effective rate was 97.2% and the case fatality rate was 2.8%. Conclusion When unexplained dyspnea occurred in patients with AECOPD and the risk factors of venous thrombosis, history of surgery within 6 weeks and bed rest (≥7 d), CTPA, MRPA, spiral CT angiography and D- Dimer and lower extremity venous ultrasound check and confirm the diagnosis, early treatment.