摘要
目的分析急性肺栓塞患者(APE)的临床特点和预后,探讨Padua和Caprini静脉血栓风险评估模型在评估急性肺栓塞患者预后中的应用价值。方法对2013年2月至2017年2月经本院确诊的44例急性肺栓塞患者进行回顾性分析,收集患者临床资料,分析患者的危险因素、临床症状,临床预后和结局。使用平行线分析和Ordinal回归分析Padua评分系统和Caprini评分系统对急性肺栓塞患者预后结局的指导作用。结果患者罹患急性肺梗塞的危险因素主要有外科大手术、慢性阻塞性肺疾病、冠状动脉粥样硬化性心脏病、脑血管病、静脉血栓史、癌症;APE常见临床症状为呼吸困难、胸痛、咳嗽、咯血;常见体征为缺乏临床特异性的心率加快、呼吸频率加快;Padua分级低危和高危的患者分别为16例、28例,组间生存时间比较差异无统计学意义(P>0.05);Caprini分级:低危、中危、高危、极高危患者分别为9例、13例、7例、15例,各组患者生存时间比较差异有统计学意义(P<0.05)。结论急性肺栓塞患者危险因素较多,临床症状和体征缺乏特异性,Padua评分对患者的预后判断无明显意义,Caprini评分可较好地预测患者的预后,分级越高,预后越差。
Objective To analyze the clinical characteristics and prognosis of patients with acute pulmonary embolism, and to explore the value of Padua and Caprini scores in predicting the prognosis of patients with acute pulmonary embolism. Methods The clinical data of 44 patients with acute pulmonary embolism were retrospectively collected;and their clinical characteristics and risk factors were analyzed. Ordinal regression was used to explore values of the two scoring systems in predicting the patients’ prognosis. Results The risk factors of the patients included surgery, COPD, coronary disease, cerebrovascular diseases, history of venous thrombosis, and cancer. The clinical characteristics included dyspnea, stethalgia, cough, hemoptysis, and tachycardia/tachypnea with no specificity. According to the Padua score, 21 cases were low risk, and 23 cases high risk;and there was no statistical difference in the survival time between the two groups (P > 0.05). In terms of the Caprini score, 9 cases were low risk, 13 medium high risk,7 high criksk, and 15 very high risk;and there were statistical differences in the survival time among these groups (all P < 0.05). Conclusions There are many risk factors of patients with acute pulmonary embolism;and their clinical characteristics are nonspecific. The Padua score is meaningless to indicate the patients' prognosis, while the Caprini can predict their prognosis;the higher the Caprini level, the worse the prognosis.
作者
傅永鸿
傅威
陈泳华
戢德宇
孙云聪
曾军
Fu Yonghong;Fu Wei;Chen Yonghua;Ji Deyu;Sun Yuncong;Zeng Jun(Department of Critical Care Medicine,Guangzhou First People’s Hospital,Guangzhou 510180,China)
出处
《国际医药卫生导报》
2019年第14期2235-2238,共4页
International Medicine and Health Guidance News
基金
广州市医药卫生科技项目(20161A010001).
