19例肺动脉栓塞诊治的临床分析.pdfVIP

昆明 医学院学报 2008。(1)：100～103 CN 53—1O49／R Journal of Kunming Medical University 1 9例肺动脉栓塞诊治的临床分析 韩胜斌，金 辉，杜 鹛 (昆明医学院第一附属医院血管外科，云南昆明 650032) [摘要]目的 总结肺动脉栓塞诊治过程中的经验和教训，降低漏诊、误诊和病死率．方法 回顾分析肺 动脉栓塞共 19例，治疗前后测得的动脉血氧分压 (Pa02)、D一二聚体 (DDi)、乳酸脱氢酶 (LDH)指标作一 自身治疗前后对照资料t检验统计．结果 19例经治疗前后PaO：、DDi和LDH经统计学检验有显著差异P 均0．05．结论 在高度疑诊时及时行DDi和CTA检查，有助于及早、正确诊断；尽快予以抗凝、溶栓治疗， 就能在最大程度上减少肺梗的发生面积，有效改善临床症状和降低致死率． [关键词]肺动脉栓塞；下腔静脉滤器；抗凝；溶栓 [中图分类号]R563．5 [文献标识码]A[文章编号]1003—4706(2008)01—0100—04 Clinical Analysis of the Diagnosis and Treatment of Pulmonary Embolism：A Report of 1 9 Cases HAN Sheng-bin，JIN Hui，DU MEI (Dept．of Vo~culo1．Surgery，The 1st Affiliated Hospital ofKunming Medical University，Kunming Yunnan 650032，China) [Abstract]Objective To reduce the rates of missed diagnosis，misdiagnosis and~tality by summarize the experiences in the diagnosis and treatment of pulmonary embolism(PE)．Methods A retrospective analysis has been performed from 19 clinically confirmed cases，all of whom were given anticoagulation and thrombolytic therapy，and 1 1 of whom (mainly with lower extremity deep venous thrombosis and malignant pelvis tumors) were implanted inferior vena cava filter(IVF)．Results All patients recovered well after treatment．Two patients (without IVF implantating)recurred PE and returned，after receiving IVF implanting plus anticoagulation and thrombolytic therapy for the second time， both patients recovered without recurrence over an 1 8-month follow-up．Indications such as PaO2，D-dimer(DDi)，and LDH were compared independently before and after treatment．showing P0．05 for al1．Conclusion Pulmonary embolism will be ultimately detected and diagnosed via carefully observation and