CAJ | 학술논문

目的：提高对肺栓塞的诊断率,降低误诊率。方法对70例肺栓塞患者的临床特点、理化检查、治疗手段及危险因素进行回顾性分析。结果70例患者中,最常见的症状为呼吸困难者占92.9%,D-二聚体>500μg/L 者占92.9%,动脉血氧分压<80 mmHg 者占95.7%,行 CT 肺动脉造影检查提示肺动脉段以上充盈缺损或肺栓塞者占92.1%,为主要诊断方法；27例患者接受溶栓治疗,40例选择单纯抗凝治疗,3例因出血未行抗凝治疗,共24例行下腔静脉滤器植入术以预防再次肺栓塞的发生；治愈7例占10%(均为溶栓治疗),好转60例占85.7%；死亡3例占4.3%(均未行溶栓治疗)。结论肺栓塞临床表现复杂,理化检查多不具特异性,CT 肺动脉造影为首选诊断方法,必要时行肺动脉造影检查,溶栓风险高,但治愈率高。
목적：제고대폐전새적진단솔,강저오진솔。방법대70례폐전새환자적림상특점、이화검사、치료수단급위험인소진행회고성분석。결과70례환자중,최상견적증상위호흡곤난자점92.9%,D-이취체>500μg/L 자점92.9%,동맥혈양분압<80 mmHg 자점95.7%,행 CT 폐동맥조영검사제시폐동맥단이상충영결손혹폐전새자점92.1%,위주요진단방법；27례환자접수용전치료,40례선택단순항응치료,3례인출혈미행항응치료,공24례행하강정맥려기식입술이예방재차폐전새적발생；치유7례점10%(균위용전치료),호전60례점85.7%；사망3례점4.3%(균미행용전치료)。결론폐전새림상표현복잡,이화검사다불구특이성,CT 폐동맥조영위수선진단방법,필요시행폐동맥조영검사,용전풍험고,단치유솔고。
Objective To improve the diagnosis of pulmonary embolism rate,decrease the rate of misdiagnosis.Methods The clinical features of 70 cases of patients with pulmonary embolism,physical and chemical examination,treatment and risk factors were retrospectively analyzed.Results In 70 patients,the most common symptoms of dyspnea accounted for 92.9%,two D-dimer > 500 μg/L was 92.9%,partial pressure of oxygen in arterial blood < 80 mmHg was 95.7%,for CTPA examination showed that the pulmonary artery or filling defect or pulmonary embolism accounted for 92.1%,as the main method for the diagnosis of 27 cases.Patients received thrombolytic therapy,40 cases of anticoagulant therapy,3 cases with hemorrhage without anticoagulant therapy,24 cases of inferior vena cava filter to prevent pulmonary embolism occurs again.Cure 7 cases accounted for 10% (all thrombolytic therapy),60 cases improved accounted for 85.7%.Three cases of death accounted for 4.3% (no thrombolytic therapy).Conclusions The clinical manifestation of pulmonary embolism complicated, physical and chemical examination was not specific,CTPA is the preferred method for diagnosis of pulmonary artery angiography,if necessary,with high risk,but high cure rate.