| 摘要: |
| 目的 探讨哑型急性肺栓塞（APE）患者的临床特点和预后。方法 51 例经肺动脉增强CT确诊，但无明显肺栓塞常见临床特征的哑型APE患者予以低分子肝素钠、华法林抗凝治疗。分析患者D- 二聚体、血管彩超、心脏彩超、心电图检查结果，并观察治疗后情况，了解哑型APE患者的临床特点及预后。结果 51 例患者均痊愈出院，4 例患者因出现活动性出血停止抗凝治疗。31 例患者在3个月后复查肺动脉增强CT 未见明显栓塞征象，其余16 例患者在4~6 月后肺栓塞征象消失。结论 哑型APE患者临床表现不典型，肺动脉增强CT 检查是明确诊断的金标准，D-二聚体、心电图等可作为相应的补充，经过恰当及时的治疗，患者预后良好。 |
| 关键词: 哑型 肺栓塞 肺动脉CT增强 低分子肝素钙 |
| DOI： |
| 分类号: |
| 基金项目:浙江省科技厅项目 |
|
| Clinical features of mute type asymptomatic pulmonary embolism |
|
FANG Jian, ZHENG Qin, WANG Lihua, LU Ming, TIAN Mingqing
|
|
Quzhou People’s Hospital
|
| Abstract: |
| Objective To review the clinical characteristics and prognosis of patients with mute type pulmonary embolism.Methods Fifty one patients with mute type pulmonary embolism received anticoagulant treatment with warfarin and low molecular weight heparin sodium. The clinical features of patients were retrospectively reviewed; the findings of D- dimer, vascular ultrasound, ultrasonic cardiogram，electrocardiogram, pulmonary artery enhanced CT were analyzed before and after treatment. Results All 51 patients were fully recovered and discharged from hospital. Anticoagulation therapy was terminated in 4 patients because of active hemorrhage. Thirty one patients had no embolism signs as indicated in enhanced pulmonary CT 3 month after treatment. The embolism signs of the remaining 16 patients disappeared after 4~6month. Conclusion The clinical manifestations of mute type pulmonary embolism were not typical, pulmonary artery enhanced CT is a gold standard for diagnosis, D-dimer, electrocardiogramcan be used as a supplementary diagnostic procedures.The prognosis of the disease should be good with appropriate treatment. |
| Key words: Mute type Pulmonary embolism Enhancement of CT in pulmonary artery Low molecular weight heparin calcium |
