摘要
活动性结核合并肺栓塞的发病率较高,临床表现多样化,病死率高,因此,早期发现及治疗对患者的预后尤为重要。本文报道1例青年男性患者,因腹胀、喘息入院。既往体健,无基础疾病。此次发病初步诊断结核病合并多浆膜腔积液、慢性心力衰竭,给予抗结核、纠正心力衰竭等治疗后,症状无缓解,病情进行性加重,进一步检查后发现合并双下肢深静脉血栓及肺栓塞。临床诊断为重症结核合并肺栓塞,加用艾多沙班等抗凝药物后,患者症状明显缓解,胸腹腔积液吸收好转出院。本文通过此病例探讨重症结核合并肺栓塞的临床特点,影像学表现,以及积极有效的综合治疗手段,并进行相关文献复习,旨在提高临床医生的警惕性,降低漏诊率,提升重症结核合并肺栓塞的诊治水平,降低死亡风险。
With the high incidence of active tuberculosis combined with pulmonary embolism,diversified clinical manifestations and high mortality rate,early detection and treatment are particularly important for the prognosis of patients.This paper reports a young male patient who was admitted to the hospital due to abdominal distension and wheezing.Previous physical health,and no underlying disease.The initial diagnosis of tuberculosis was combined with multiple serosal fluid effusion,chronic heart failure.After anti-tuberculosis and corrected heart failure,the symptoms were not relieved and the condition was gradually aggravated.After further examination,it was found with deep vein thrombosis and pulmonary embolism of both lower limbs.The clinical diagnosis was severe tuberculosis with pulmonary embolism,and after the addition of anticoagulant drugs such as edoxaban,the patient's symptoms were significantly relieved,and the thoracic and abdominal fluid absorption was improved and discharged from hospital.Through this case,this paper discusses the clinical characteristics,imaging manifestations of severe tuberculosis combined with pulmonary embolism,and the active and effective comprehensive treatment methods,and discusses the relevant literature review,aiming to improve the vigilance of clinicians,reduce the rate of missed diagnosis,improve the diagnosis and treatment level of severe tuberculosis combined with pulmonary embolism,and reduce the risk of death.
作者
熊艳美
李同心
杨松
孙楠楠
Xiong Yanmei;Li Tongxin;Yang Song;Sun Nannan(Department of Comprehensive Internal Medicine,Chongqing Public Health Medical Center,Chongqing 400030,China;Department of Central Laboratory,Chongqing Public Health Medical Center,Chongqing 400030,China)
出处
《新发传染病电子杂志》
2024年第1期47-50,共4页
Electronic Journal of Emerging Infectious Diseases
基金
重庆市科卫联合医学科研项目(2024MXSM061)。
关键词
肺栓塞
重症结核
结核性多浆膜腔积液
抗结核治疗
抗凝
Pulmonary embolism
Severe tuberculosis
Tuberculous polyserous effusion
Anti-tuberculosis
Anti-coagulation
