CAJ | 학술논문

目的探讨肺血栓栓塞症患者的诊断方法及危险因素。方法选择本院确诊为肺血栓栓塞症的患者83例，回顾性分析所有患者的危险因素、临床表现和辅助检查结果。结果呼吸困难为肺血栓栓塞症最早出现也是最常见的症状。肺血栓栓塞症时可有PaO2和PaCO2下降、pH升高、肺泡-动脉血氧分压差增大，血液中D-二聚体浓度升高(>500ng/ml)，心电图SIQⅢTⅢ表现，超声心动图可见肺动脉压增高、右心扩大和三尖瓣反流增快。 V/Q扫描及CTPA检查可确诊肺血栓栓塞症。肺血栓栓塞症的高危因素主要年龄、高血压、冠心病、下肢深静脉血栓形成、脑梗死及手术外伤。结论由于大多数肺血栓栓塞症患者的临床表现不典型，临床上对于存在肺血栓栓塞症高危因素的患者应提高警惕，及早联合应用V/Q扫描及CTPA检查予以确诊以减少误诊率及漏诊率。
목적탐토폐혈전전새증환자적진단방법급위험인소。방법선택본원학진위폐혈전전새증적환자83례，회고성분석소유환자적위험인소、림상표현화보조검사결과。결과호흡곤난위폐혈전전새증최조출현야시최상견적증상。폐혈전전새증시가유PaO2화PaCO2하강、pH승고、폐포-동맥혈양분압차증대，혈액중D-이취체농도승고(>500ng/ml)，심전도SIQⅢTⅢ표현，초성심동도가견폐동맥압증고、우심확대화삼첨판반류증쾌。 V/Q소묘급CTPA검사가학진폐혈전전새증。폐혈전전새증적고위인소주요년령、고혈압、관심병、하지심정맥혈전형성、뇌경사급수술외상。결론유우대다수폐혈전전새증환자적림상표현불전형，림상상대우존재폐혈전전새증고위인소적환자응제고경척，급조연합응용V/Q소묘급CTPA검사여이학진이감소오진솔급루진솔。
Objective Analysis the diagnosis method and risk factors of Pulmonary thrombo-embolism ( PTE ) Pa-tients. Method The risk factors, clinical presentation and results of auxiliary examinations in 83 PTE patients were retrospectively analyzed. Result Dyspnea was the earliest and most frequent symptom in PTE patients. PTE could have PaO2 and PaCO2 decreased, pH value increased, the difference of Alveolar arterial oxygen partial pressure in-creased. The concentration of D-dimer in blood increased. And with a SIQⅢTⅢperformance in electrocardiogram. The echocardiogram may have performance of pulmonary hypertension, right heart enlargement and atrioventricular valve reflux quicker. Ventilation-perfusion scintigraphy ( V/Q scan) and Helico-Computerized Tomography Pul-monary Arteriography(CTPA) could identify PTE. The main risk factors for PTE were age, hypertension(HBP), coronary heart disease( CHD) ,deep venous thrombosis( DVT) , cerbral infarction, operation and/or trauma. Con-clusion Because most PTE patients have no typical clinical presentation, we should raise our vigilance when we make our diagnosis on patients who have risk factors of PTE. The combined application of V/Q scan and CTPA ear-lier could reduce the misdiagnosis rate and missed diagnosis.