肺栓塞呼吸内科诊断治疗剖析.docVIP

肺栓塞呼吸内科诊断治疗剖析 　　[摘要] 目的 探讨肺栓塞的危险因素与发病的关系及肺栓塞的诊断程序与治疗对策。 方法 对该院2009年1月―2011年1月期间呼吸内科收治的40例肺栓塞患者临床诊治效果进行分析。 结论 心动图正常者11例，右室扩大10例，肺动脉高压、室壁运动异常患者有19例，血气分析pH7.45者有12例，PaO280 mmHg有38例。血常规检查白细胞数量增多9例，血沉加快8例，血总胆红素增高10例。治疗组采用尿激酶溶栓联合抗凝药物进行治疗，有5例治愈，6例显效，7例好转；2例治疗无效，有效率为90.0%。而对症治疗组患者治愈2例，显效5例，好转6例，无效7例，总有效率为65.0%。 结论肺栓塞临床病症复杂，临床早期确诊并采用溶栓抗凝治疗对提高肺栓塞患者的生存率及治疗效果具有重要的意义。 　　[关键词] 呼吸内科；肺栓塞；诊治；分析 　　[中图分类号] R563 [文献标识码] A [文章编号] 1674-0742（2013）06（c）-0023-02 　　Respiratory Department of Internal Medicine Diagnosis and Treatment of Pulmonary Embolism 　　LIU Jiandong 　　Xinyi， Guangdong Peoples Hospital，Xinyi 525300，China 　　[Abstract] Objective To investigate the risk factors for pulmonary embolism and the pathogenesis of pulmonary embolism and diagnostic procedures and treatment measures. Methods In our hospital in 2009 January ～2011 year in January during the respiratory department of internal medicine treated 40 cases of pulmonary embolism in patients with clinical diagnosis and treatment were retrospectively analyzed. Conclusion Heartbeat of normal in 11 cases， right ventricular enlargement in 10 cases， pulmonary arterial hypertension， ventricular wall motion abnormalities in patients with 19 cases， blood gas analysis in 12 cases of pH 7.45， PaO2 38 cases in 80mmHg. Blood routine examination of 9 cases with increased white blood cell count， erythrocyte sedimentation rate accelerated in 8 cases， 10 cases of serum total bilirubin. The treatment group treated by urokinase combined anticoagulant drug treatment， 5 cases were cured， 6 cases improved， 7 cases； 2 cases ineffective treatment， efficiency of 90%. While symptomatic patients in the treatment group 2 cases were cured， 5 cases were improved， 6 cases improved， 7 cases are invalid， the total efficiency of 65%. Conclusion Pulmonary embolism clinical symptom complex， clinical early diagnosis and the use of thrombolytic and anticoagulant therapy in patients with pulmonary embolism to improve survival rate and treatment effect has