腹股沟疝合并肺血栓栓塞症17例临床分析-国家心血管病中心.PDFVIP

中国循环杂志 2015 年 4 月 第 30 卷 第 4 期（总第 202 期）Chinese Circulation Journal，April，2015，Vol. 30 No.4（Serial No.202） 363 临床研究 腹股沟疝合并肺血栓栓塞症 17 例临床分析 * ** 刘加良，陈文宇 ，张齐，马肖龙，曹伟中 摘要 目的：总结腹股沟疝合并肺血栓栓塞症患者的临床特点及预后。 方法：回顾性分析了嘉兴市第一医院 2009-01 至 2014-05 期间所确诊的 17 例腹股沟疝合并肺血栓栓塞症患者的临 床特征、辅助检查结果及治疗效果。 结果：本研究中男性患者最常见，男女比例为 4.67:1，腹股沟区可触及包块、呼吸困难及发绀是最常见的临床症状 和体征。17 例患者血浆 D- 二聚体均 500 μg/L，12 例动脉血气分析异常，16 例心电图提示异常，14 例超声心动图提 示异常，4 例双下肢血管彩色超声检查提示存在下肢静脉血栓，10 例腹股沟彩色超声检查提示左腹股沟疝，7 例提示右 腹股沟疝。6 例患者行 X 线胸片检查，4 例存在影像学改变。15 例患者行肺动脉计算机断层摄影（CT）血管造影检查均 出现特征性影像学改变。经治疗后，17 例患者中有 4 例死亡，死亡率 23.5%。 结论：腹股沟疝合并肺血栓栓塞症极易漏诊，且病死率高，故应提高临床诊治水平，通过早期诊断和治疗来改善 该类患者的预后。 关键词 腹股沟疝；肺血栓栓塞症；临床特点 Clinical Analysis of Inguinal Hernia Combining Pulmonary Thromboembolism in 17 Patients LIU Jia-liang, CHEN Wen-yu, ZHANG Qi, MA Xiao-long, CAO Wei-zhong. Department of Respiration, The First Hospital of Jiaxing City, Jiaxing (314001), Zhejiang, China Corresponding Author: CHEN Wen-yu, Email: 1984423@163.com Abstract Objective: To summarize the clinical features and prognosis of inguinal hernia combining pulmonary thromboembolism (PTE) in 17 patients. Methods: A total of 17 patients with confirmed diagnosis of inguinal hernia combining PTE treated in our hospital from 2009-01 to 2014-05 were retrospectively analyzed. The clinical features, laboratory tests, treatment and prognosis were investigated in all patients. Results: There were more patients with male gender and the ratio of male/female was 4.67/1. The most common clinical symptoms were palpable mass at groin area, dyspnea and cyanosis. All 17 patients had plasma D-dimmer 500 μg/L, there were 12/17 patients with abnormal arterial blood gas analysis, 16 with abnormal ECG, 14 with abnormal echocardiography, and ultrasou