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目的初步探讨肺栓塞的急诊诊治思路,提高急诊医师对肺栓塞的认识,提高早期诊断率。方法分析30例肺栓塞患者的临床表现及相关辅助检查,归纳其临床特点。结果临床表现缺乏特异性,易患因素为下肢深静脉血栓、高龄、长期卧床、恶性肿瘤、近期有手术史、骨折等,临床遇到不明原因的呼吸困难、胸痛、咯血、咳嗽及晕厥,不明原因的心悸、低血压状态或休克,突发的急性右心力衰竭等要警惕肺栓塞可能,血浆D-二聚体检测是最有效的肺栓塞筛选方法,CTPA是常用的确诊方法。结论急诊工作中对有高危因素患者进行D-二聚体检测加CTPA,可以明确有无肺栓塞情况。
Objective To investigate the emergency diagnosis and treatment of pulmonary embolism, to improve emergency physicians understanding of pulmonary embolism and improve the early diagnosis rate. Methods The clinical manifestations and related auxiliary examinations of 30 patients with pulmonary embolism were analyzed and the clinical features were summarized. Results The clinical manifestations of the lack of specificity, predisposing factors for lower extremity deep vein thrombosis, elderly, bedridden, malignant tumors, recent surgery history, fractures, clinical encounter unexplained dyspnea, chest pain, hemoptysis, cough and fainting, unknown Cause of palpitations, hypotension or shock, sudden acute right heart failure to be alert to possible pulmonary embolism, plasma D-dimer detection is the most effective screening method for pulmonary embolism, CTPA is commonly used method of diagnosis. Conclusion D-dimer and CTPA in patients with high risk factors during emergency work can confirm the presence or absence of pulmonary embolism.