Clinical Analysis Of 40 Cases Of Pulmonary Embolism

Objective:To analyse the clinical feature of pulmonary embolism(PE),such as predisposing factors,symptom and so on.And to approach the methods of diagnose and treatment,compare the feature of elder(≥60 years old) and younger(＜60 years old) PE patients.Therefore we can decrease misdiagnosis rate and missed rate,and achieve safe efficient treatment.Method:Data of hospitalization patients with PE in the first affiliated hospital of Jinan University from January 2000 to February 2009 were analyzed retrospectively,including general information,length of stay,predisposing factors,clinical manifestation,laboratory data, imageology data,treatment,and turnover.The frequency of the data was calculated,and the clinical features of different age(elder and younger) PE patients were compared by statistics means.Results:1.Lower limb vein disease(mainly lower limb deep venous thrombosis(DVT)), malignant tumor,and the heart and lung disease were the common predisposing factors.2. Dyspnea was the most common symptom of PE(82.5%).The frequency of typical triad of chest pain,hemoptysis and dyspnea was 7.5%.Tachypnea(60%)%) was the most common sign.The frequency of symptom and sign in lower limb DVT was 27.5%.3.The frequency of hypoxemia (PaO₂＜7.98 kpa) in blood gas analysis was 25%.4.The positive frequency of D-dimer test was 92.9%by latex particle agglutination,and the positive frequency of D-D test in 4 cases was 100%by VIDAS- enzyme linked immunosorbent assay.5.77.4%secondum lung pathological change shadow was found by chest x-ray film.The frequency of S_â… Q_â…¢T_â…¢of Electrocardiogram was 15.2%,sinus tachycardia was 51.5%,right bundle branch block/immaturity right bundle branch block was 24.2%,chest lead T wave inversion was 34.4%.And there was no significance difference after treatment.6.1 case right ventricular wall motion decrudescence,and 84.4%right ventricular dilatation,63.3%right atrial enlargement,71.9%pulmonary hypertension,and 75% valvula tricuspidalis back-streaming were found by Echocardiography.7.The frequency of pulmonary artery filling defect was 96.2%by computed tomography pulmonary angiography (CTPA).And CTPA could fred lung pathological change shadow,pulmonary hypertension and pleural effussion.8.The effective power of thrombolysis was 76.9%,and the effect of anticoagulation was 86.7%.There was significance difference compared to general treatment(P ＜0.05).The rate of bleeding adverse effect of thrombolysis was 23.1%,severe bleeding was 7.7%.And of anticoagulation was 13.3%and 6.7%.9.There was more frequency of hypertension in elder PE patients.(P＜0.05).Conclusion:Lower limb vein disease,malignant tumor and the heart and lung disease are common predisposing factors.CTPA can make precise diagnose.The effective power of treating PE with thrombolysis and anticoagulation was 76.9%and 86.7%respectively.And the rate of severe bleeding was 7.7%and 6.7%respectively.