摘要
目的探讨老年肺血栓栓塞症的，临床特点、诊断方法、不同治疗方案及其疗效。方法回顾性分析我院2001～2007年确诊为肺血栓栓塞症的48例老年患者的临床资料，根据治疗方法分为溶栓组（10例）、抗凝组（20例）及抗血小板组（18例）。对肺血栓栓塞症的发病诱因、诊断方法和不同治疗方案及疗效进行分析。结果肺血栓栓塞症的临床表现无明显特异性，以呼吸困难及胸痛为主要临床表现，在实验室检查中放射性核素肺灌注通气检查阳性率高，心电图可表现为窦性心动过速，ST—T改变，S1QⅢTⅢ征，超声心动图可表现为右心房、右心室增大，三尖瓣反流及肺动脉高压，溶栓组痊愈7例，好转2例，死亡1例；抗凝组痊愈11例，好转9例；抗血小板组痊愈4例，好转7例，死亡7例。溶栓组与抗凝组疗效无统计学差异，溶栓组与抗血小板组及抗凝组与抗血小板组间疗效均有统计学差畀（P〈0．05）。结论肺血栓栓塞症的临床表现多样，溶栓及抗凝治疗均可有效改善预后，单纯抗血小板治疗效果不佳。
Objective To investigate the clinical characteristics, diagnosis, different treatment regimens and their therapeutic efficacy in pulmonary thromboembolism of the elderly. Methods The clinical data of 48 patients with pulmonary thromboembolism were retrospectively analyzed. According to different treatment methods,the patients were divided into thrombolytic therapy group （10 patients）, anticoagulative therapy group（20 patients） and antiplatelet therapy group（18 patients）. The predisposing cause, diagnosis, different treatment regimens and therapeutic efficacy were analyzed. Results Clinical symptoms were not specific and most patients had dyspnea and chest pain. The positive rate of pulmonary perfusion/ventilation scan with radionuclide was very high, ECG changes were sinus tachycardia,the changes of the ST-T and the S1 QⅢ TⅢ sign. Echocardiography demonstrated right ventricle and right atrium enlargement, tricuspid regurgitation and pulmonary hypertension. Ten patients received thrombolytic therapy. Of them, 7 were cured, 2 were improved and one died. Twenty patients received anticoagulative therapy. Of them, 11 were cured and 9 were improved. Eighteen patients received antiplatelet therapy. Of them, 4 were cured, 7 were improved and 7 died. Thrombolytic therapy and anticoagulative therapy had good efficacy,while the efficacy of antiplatelet therapy was unsatisfactory. Conclusion The clinical manifestations of pulmonary thromboembolism are varied. Thromholytic therapy and anticoagulative therapy can effectively improve the prognosis of pulmonary thromboembolism patients,while the efficacy of antiplatelet therapy is not good.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2008年第10期754-756,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
肺栓塞
血栓溶解疗法
抗凝药
危险因素
预后
pulmonary embolism
thrombolytic therapy
anticoagulants
risk factors
prognosis
