岭南心血管病杂志
嶺南心血管病雜誌
령남심혈관병잡지
SOUTH CHINA JOURNAL OF CARDIOLOGY
2009年
3期
204-206
,共3页
温勇伟%许顶立%叶桃春%吴雷%沈安娜
溫勇偉%許頂立%葉桃春%吳雷%瀋安娜
온용위%허정립%협도춘%오뢰%침안나
肺栓塞%心力衰竭%心室功能障碍,右
肺栓塞%心力衰竭%心室功能障礙,右
폐전새%심력쇠갈%심실공능장애,우
pulmonary embolism%heart failure%ventricle functional disturbance
目的 探讨肺栓塞(pulmonary embolism,PE)的诊断、治疗及预后特点及2001年我国肺血栓栓塞症的诊断与治疗指南颁布后对其的影响.方法 回顾性分析85例PE患者的临床资料、着重分析其临床特点、诊断、治疗及预后.结果 71.8%(61/85)行螺旋CT检查确诊,16.5%(14/85)行放射性核素肺通气灌注扣描确诊,10.6%(9/85)行肺动脉造影检查确诊,1.2%(1/85)行尸体解剖检查确诊,共有34.1%(29/85)误诊为其他疾病.33例接受溶栓治疗前后行心脏超声检查,溶栓治疗后较治疗前比较,右心室直径、右心室/左心室舒张末期直径、收缩期肺动脉压显著性下降.根据患者入院的时间将其分为两组,1997年1月～2001年12月入院的患者设为A组,共35例;2002年1月～2008年7月入院的患者设为B组,共50例.B组住院病死率、误诊率较A组明显降低,差异有统计学意义[22.0%比45.7%,χ2=5.342,P=0.021;24.0%比48.6%,χ2=5.530,P=0.019].结论 我国肺血栓栓塞症指南的颁布对减少PE的误诊率、住院病死率有一定帮助,溶栓治疗可以改善PE患者右心室功能不全.
目的 探討肺栓塞(pulmonary embolism,PE)的診斷、治療及預後特點及2001年我國肺血栓栓塞癥的診斷與治療指南頒佈後對其的影響.方法 迴顧性分析85例PE患者的臨床資料、著重分析其臨床特點、診斷、治療及預後.結果 71.8%(61/85)行螺鏇CT檢查確診,16.5%(14/85)行放射性覈素肺通氣灌註釦描確診,10.6%(9/85)行肺動脈造影檢查確診,1.2%(1/85)行尸體解剖檢查確診,共有34.1%(29/85)誤診為其他疾病.33例接受溶栓治療前後行心髒超聲檢查,溶栓治療後較治療前比較,右心室直徑、右心室/左心室舒張末期直徑、收縮期肺動脈壓顯著性下降.根據患者入院的時間將其分為兩組,1997年1月～2001年12月入院的患者設為A組,共35例;2002年1月～2008年7月入院的患者設為B組,共50例.B組住院病死率、誤診率較A組明顯降低,差異有統計學意義[22.0%比45.7%,χ2=5.342,P=0.021;24.0%比48.6%,χ2=5.530,P=0.019].結論 我國肺血栓栓塞癥指南的頒佈對減少PE的誤診率、住院病死率有一定幫助,溶栓治療可以改善PE患者右心室功能不全.
목적 탐토폐전새(pulmonary embolism,PE)적진단、치료급예후특점급2001년아국폐혈전전새증적진단여치료지남반포후대기적영향.방법 회고성분석85례PE환자적림상자료、착중분석기림상특점、진단、치료급예후.결과 71.8%(61/85)행라선CT검사학진,16.5%(14/85)행방사성핵소폐통기관주구묘학진,10.6%(9/85)행폐동맥조영검사학진,1.2%(1/85)행시체해부검사학진,공유34.1%(29/85)오진위기타질병.33례접수용전치료전후행심장초성검사,용전치료후교치료전비교,우심실직경、우심실/좌심실서장말기직경、수축기폐동맥압현저성하강.근거환자입원적시간장기분위량조,1997년1월～2001년12월입원적환자설위A조,공35례;2002년1월～2008년7월입원적환자설위B조,공50례.B조주원병사솔、오진솔교A조명현강저,차이유통계학의의[22.0%비45.7%,χ2=5.342,P=0.021;24.0%비48.6%,χ2=5.530,P=0.019].결론 아국폐혈전전새증지남적반포대감소PE적오진솔、주원병사솔유일정방조,용전치료가이개선PE환자우심실공능불전.
Objectives To investigate the diagnosis, treatment and prognosis of patients with pulmonary embolism (PE), and the impact to them after the promulgation of 2001 Chinese Guidelines on the diagnosis and treatment of pulmonary thromboembolism and PE. Methods The clinical data of 85 patients with PE were retrospectively analyzed, focused on the diagnosis, treatment and prognosis. Results Seventy-one point eight percent (61/85) patients were diagnosed by spiral CT, 16.5% (14/85) patients were diagnosed by radioactive nuclide ventilation perfusion scan, 10.6% (9/85) patients were diagnosed by pulmonary arteriography, 1.2% (1/85) patients were diagnosis by autopsy examination. There were 34.1% (29/85) patients who were misdiagnosed in all. Compared with before thrombolysis, the heart ultrasonic inspection indicated that the right ventricular dimension, right ventricular end-diastole diameter/ left ventricular end-diastole diameter, systolic phase pulmonary pressure were lower in 33 patients after thrombolysis. Thirty-five patients who admitted hospital from January 1997 to December 2001 were in group A, 50 patients who admitted hospital from January 2002 to July 2008 were in group 8. Compared with group A,the in-hospital mortality rates and misdiagnosis rate were lower in group B, the difference has statistical significance [22.0% vs. 45.7%, χ2=5.342, P=0.021; 24.0% vs. 48.6%, χ2=5.530, P=0.019]. Conclusions It is helpful to reduce misdiagnosis rate and in-hospital mortality rate after the promulgation of Chinese Guidelines on the diagnosis and treatment of pulmonary thromboembolism and PE. Insufficient function of right ventricle in patients with PE can be improved after thrombolysis.
