摘要
目的 探讨急诊肺栓塞 (PE)快速、准确、实用的诊断方法。方法 对 52例确诊为急性肺栓塞的急诊患者的发病原因、临床症状、体征、化验室检查、X线、ECG、U CG、肺通气 /灌注扫描(V/Q)等进行回顾性分析和总结。结果 血气分析、D- 聚体 (D- Dimer)测定是 PE的初步筛选手段 ,阳性率 Pa O2 为 6 5.9% ;Pa CO2 为 53.1% ;D- Dimer为 70 %。X线胸片可作为提示性依据 ,非特异性片状阴影出现率为 4 3.5%。ECG特异性改变 (S Q T )发生率仅为 3.8% ,只可作为 PE的参考依据。UCG能较明确地反映 PE的右室负荷增加征象 ,肺动脉直径增宽发生率为 75% ;右心室扩大 94 .4 % ;肺动脉高压 6 4 % ;V/Q可作为急诊诊断 PE较为可靠的手段 ,阳性率达 10 0 %。结论 对以呼吸困难、气短等呼吸系统症状就诊的急诊患者 ,应提高对 PE的警惕 ,按上述程序进行综合检查 ,可以快速、准确、实用地对
Objective To research fast,accurate and practical methods for diagnosis of acute pulmonary embolism (PE) in emergency department.Methods Fifty two cases of confirmed PE were involved in this study.The pathogenesis,clincal symptoms,signs,lab examination,X ray and ECG,UCG,pulmonary perfusion ventilation scanning (V/Q) and pulmonary arteriography were retrospectively analyzed.Results The blood gas analysis and D Dimer test were the primary screening methods for PE.Positive rate of PaO 2 was 65.9%,PaCO 2 53.1%,D Dimer 70%.Chest X ray scanning might only give some hints for the diagnosis because only 43.5% non spective pieces of shadow occurred on the lungs.ECG spective changes (S ⅠQ ⅢT Ⅲ) were menely 3.8%.UCG was able to clearly feature the increased right ventricular load,in which more than 75% cases were found the diameter of pulmonary artery increasing,94.4% right ventricular enlargement,64% pulmonary artery high pressure.V/Q was a reliable method to diagnose PE in emergency department,owing to its 100% positive rate.Conclusions We should be alert of PE in patients who suffer from acute dyspnoea、short of breath.A combination of above mentioned methods may make a fast and accurate diagnosis of PE.
出处
《北京医学》
CAS
北大核心
2000年第3期149-152,共4页
Beijing Medical Journal
关键词
急诊
诊断
放射性核素显像
超声心动图
Pulmonary embolism Radionuclide imaging Echocardiography
