摘要
目的分析急性大面积肺动脉血栓栓塞症的临床特征以及溶栓治疗的疗效,以降低漏诊和误诊率,提高生存率。方法分析沈阳军区总医院呼吸内科住院的33例急性大面积肺血栓栓塞症患者的临床资料。结果 79%患者就诊经历了2家或以上医院才得以确诊,首诊科室以急诊科、呼吸科和心内科为主。危险因素包括年龄、心脏疾病、恶性肿瘤等。临床症状以呼吸困难最为常见,其次为晕厥,出现"三联征"症状极少。100%患者经肺CTPA确诊。尿激酶与rt-PA两种溶栓药物在治疗效果上差异无显著意义(χ2=0.968,P>0.05)。结论急性大面积肺动脉血栓栓塞症诊断意识有待于提高。临床症状复杂多样,对于有晕厥患者,应考虑本病可能;肺CTPA可做为确诊首选检查。确诊后立即规范化溶栓等治疗,可显著改善预后。
Objective To discuss clinical characteristics of AM-PTE and therapeutic effect of thrombolysis so as to reduce false or misdiagnosis rate and improve survival rate. Methods The clinical data of 33 impatients with AM-PTE were reviewed. Results 79% patients undergo at least two hospitals to finial diagnosis, the main departments included emergency, respiratory and cardiovascular medi- cine. The common risk factors were age over 60 years old, cardiac disease, turner, etc. The most frequent symptom was dyspnea, the second is syncope. All the patients were finally diagnosed by CTPA. Urokinase and rt-PA had no differences in thrembolysis. Conclusion Clini- cians should improve consciousness of disease, when the patient has syncope, we should think of it. CTPA Can be used preferred examina- tion. The quick standardized treatment can improve prognosis significantly.
出处
《临床肺科杂志》
2013年第4期665-666,共2页
Journal of Clinical Pulmonary Medicine
