冠状动脉造影术后并发急性肺栓塞5例分析.docVIP

冠状动脉造影术后并发急性肺栓塞5例分析 　　摘 要 目的：分析冠状动脉造影术后并发急性肺栓塞的临床特点和危险因素，提出预防和处理的措施。方法：针对我院发生的5例冠状动脉造影术后急性肺栓塞患者，了解肺栓塞的临床表现、实验室检查方法和治疗措施等。结果：冠状动脉造影术后并发的急性肺栓塞在临床上主要表现为呼吸困难、胸闷、心跳加快和低血压等，部分患者可并发下肢深静脉血栓形成。检查手段包括心电图、超声心动图、动脉血气、D-二聚体水平、肺动脉计算机断层扫描血管造影和肺动脉造影等。结论：冠状动脉造影术后并发的急性肺栓塞的病情危急，尽早诊断、尽早治疗可挽救患者生命，同时应加强预防措施。 　　关键词 肺栓塞 冠状动脉造影术 介入治疗 　　中图分类号：R619.2； R543.2 文献标识码：C 文章编号：1006-1533（2014）15-0018-04 　　Outcome of five cases of acute pulmonary embolism after coronary arteriography 　　Hang Yanwen， Zhang Xiaochun， Li Zhishan， Zhou Daxin* 　　（Department of Cardiology， Zhongshan Hospital， Fudan University； 　　Shanghai Institute of Cardiovascular Disease， Shanghai 200032， China） 　　Abstract Objective： To analyze the clinical and risk factor of acute pulmonary embolism after coronary arteriography and to find out methods for its treatment and prevention. Methods： Five cases of acute pulmonary embolism after coronary arteriography were included in this study. We analyzed its clinical characteristics， laboratory examinations， treatment and effects. Results： The major clinical manifestations of acute pulmonary embolism after coronary arteriography appeared as breathing difficulty， chest tightness， rapid heartbeat and low blood pressure， and deep vein thrombosis may be complicated in some patients. The diagnosis was based on the results from examination by D-dimers level， ECG， ultrasound cardiograph， leg vein Doppler， pulmonary computed tomographic angiography and selective pulmonary angiography. Conclusion： Early diagnosis and early treatment should be performed to save the lives of patients since the acute pulmonary embolism after coronary arteriography is usually in critical condition， and meanwhile effective measures should be taken to prevent it from occurrence. 　　Key words pulmonary embolism； coronary arteriography； interventional therapy 　　肺栓塞（pulmonary embolism）是以各种栓子阻塞肺动脉系统为发病原因的一组疾病的总称，曾被认为少见而未获得足够的认识。近年来，随着检查手段的进步和诊治水平的提高，肺栓塞在临床上渐趋多见。约20%的肺栓塞继发于手术后，占术后死亡病例总数的15%[1]。不过，因接受介入诊疗而并发的肺栓塞仍未得到