目的:分析并总结我院收治、确诊的35例急性肺栓塞患者的早期临床表现、诊断及其治疗过程,逐步提高我院急性肺栓塞的诊断率,改善疗效.方法:自我院2008年3月开始收治的35例急性肺栓塞患者为研究对象,认真观察、询问、记录其发病的经过、辅助检查、诊断以及治疗情况.结果:辅助检查结果显示35例患者中,27例动脉血气分析有低氧血症、低碳酸血症;血清学检查19例LDH不同程度增高;持续性低血压患者18例;肌钙蛋白正常患者12例;血浆D-二聚体检测500μg/L以上者为25例;心电图检查SIQⅢTⅢ征阳性者11例;超声心动图提示肺动脉高压23例,同时伴有右心血栓7例;螺旋CT/MRI/肺动脉造影阳性35例.结论:提高急性肺栓塞早期诊断率,及早对其进行溶栓等治疗对提高患者预后十分重要.%Objective: To analyze and summarize the early clinical manifestation, diagnosis and treatment process of 35 cases of acute pulmonary embolism, whom were received and cured, and made definited diagnosis in our hospital, and to gradually improve the acute pulmonary embolism diagnostic rate for improving the curative effect. Method: Regard 35 cases of acute pulmonary embolism patients as the research object whom were received and cured from March 2008 in our hospital. Observed, inquiried, recorded the pathogenetic after auxiliary examination, diagnosis and treatment seriously. Result: The auxiliary examination results showed that in the 35 cases of patients, there were 27 cases hyoxemia, 19 cases with varying degree increase of LDH by the Serology Test;18 cases with sustained hypotension;12 cases of normal troponin;25 cases of the plasma d-dimer tested more than 500 μLg/L;11 cases with SIQ Ⅲ T Ⅲ sign positive of ECG examination;the ultrasonic cardiogram prompt pulmonary hypertension in 23 cases, 7 cases accompany right heart thrombus;19 cases have typical signs in the nuclide pulmonary ventilation/perfusion scan;31 cases sign positive in the Spiral CT/MRI/pulmonary angiography. Conclusion: To improve the diagnostic rate of acute pulmonary embolism at the early stage, and as earlier as it was diagnostic the thrombolytic treatment and so on were taken, all of these are very important for the patients to improve prognosis.
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