Comparative Clinical Analysis Of 163 Pulmonary Thromboembolism Patients

Objective 1.Contrast the clinical data of pulmonary thromboembolism applied with standardized diagnosis and treatment and not.To explore the significancy of PTE standardized diagnosis and treatment of pulmonary thromboembolism.2.Analyze the diagnosis and treatment status of pulmonary thromboembolism confirmed diagnosis patients and summarize the characteristic of these clinical data to provide reference to the diagnosis and treat of pulmonary thromboembolism.Method The clinical data of 163 Consecutive patients with PTE were reviewed retrospectively from Jan 1972 to Dec 2006 in the first affiliated hospital of guangxi medical university.All of patients were divided into group A (Jan 1972 to May 2002)and group B(June 2002 to Dec 2006)by the time of applying standardized treatment and diagnose of PTE in our hospital,then do the contrast analysis of these clinical data.Results Dyspnea is the most important clinical symptoms,group A and B patients with dyspnea incidence rate is 92.5 percent and 84.6 percent Relative to group A,the diagnostic case of group B is increasing year by year.Group A has 40 cases and group B has 123 cases,the average diagnostic case is 1.3 cases per year and 24.3 cases per year respectively.The ratio of final diagnosis is 27.5 percent and 76.4 percent in group A and group B respectively,the P value is less than 0.01.The median time to diagnosis is 10.0±6.0 days and 5.0±6.9 days in group A and group B respectively,the P value is less than 0.01.The case do antithrombotic therapy and thrombolytic therapy is increasing,was 9 cases(22.5 percent)and 84 cases(68.2 percent)in group A and group B respectively,the P value is less than 0.01.The in-hospital mortality is decreasing,was47.5 percent and 23.6 percent in group A and group B respectively,the P value is less than 0.01.We chose CTPA predominatingly,we diagnose 76 cases with CTPA in 94 PTE patients with 80.9 percent.All of them 11 patients(11.7 percent)diagnose with CTPA and ECT,the diagnostic accordance rate is 100%.The signs of right ventricular high load or pulmonary hypertension in ultrasonic cardiography were more common massive PTE than non-massive PTE,the P value is less than 0.05.Conclusion 1.The significant increase of the diagnostic case,the ratio of final diagnosis and effective treatment of PTE,also the shorten of time diagnose, the decrease of in-hospital mortality after 2002 in our hospital benefit from participation in in the "The 10th Five-Year Plan" national research project on "PTE standardized method of treatment and diagnose."The introduction of PTE standardized treatment and diagnose procedure promotes the diagnostic work of pulmonary thromboembolism in our hospital.2.Dyspnea is a common symptom of pulmonary embolism,we should be alert to pulmonary embolism for unknown reasons Dyspnea.3.The CTPA has the characteristics like safety,time saving,shortcut,Noninvasive,and also can exclude the other lung diseases and display distinctly the position of pulmonary artery thromboembolism,will be the first way of final diagnosis.4.Right ventricular dysfunction and pulmonary hypertension signs were found in massive PTE more in Echocardiographic examination.So the Echocardiographic examination is a meaningful way to Critical condition patients.5.It can significantly reduce mortality and improve the cure rate by Standardization of thrombolysis and anticoagulation therapy...