Clinical Analysis Of Acute Pulmonary Embolism

Objective: To improve diagnosis and treatment of acute pulmonary embolism （APE） throughanalysis of clinical features and observe the clinical safety of thrombolysis and anticoagulationtherapy. Therefore we can decrease misdiagnosis rate and missed rate, and achieve safe efficienttreatment.Methods: Date of hospitalization patients with acute in the first affiliated hospital of XinJiangShihezi University from January2008to February2012were analyzed retrospectively，includinggeneral information，predisposing factors，clinical manifestations，laboratory data，imageologydata，treatment and turnover，the clinical data statistics the happening of the frequency, and theapplication of statistics methods to analyze the therapeutic effect of different treatments andprognosis.Results：1. Older patients （>60years）, smoking, lower limb venous disease, surgery，hypertension,coronary heart disease is a common susceptible to pulmonary embolism,40cases of two ormore risk factors.2. One of the most common symptoms are shortness of breath, followed by, hemoptysis, chestpain and coughing, hemoptysis patients,11cases （21.2%）, no big hemoptysis. Body can befound for more than50%of the patients with tachycardia and shortness of breath. DVT in12patients （22.2%）. In addition, a typical views on dyspnea, hemoptysis, chest pain only in5cases （9.6%） in patients with acute APE.3. Arterial blood gas analysis found that hypoxemia (10.7kpa （PaO₂</80mmHg）(that is, theoxygen partial pressure （80mmHg）42cases （93.3%）.4. Immune turbidimetry quantitative test, of which45cases （95.7%）> D-dimer result500ng/ml.5. X-ray chest radiograph has96%of the secondary changes of lung tissue. Specific changes oftypical S_IQ_IIIT_IIIis6.1%, sinus tachycardia positive rate was61.2%,28.6%of chest lead Twave inversion, RBBB/IRBBB6.1%.6. Echocardiography found13cases of pulmonary hypertension （31.0%）, right ventricular wallmotion decreased in12cases （28.6%）,15cases （35.7%）, tricuspid regurgitation, rightventricular expansion of7cases （16.7%）, pericardial effusion in1case （2.4%）. Dopplerultrasound of the blood vessel （DVUS） found in12cases of venous thrombosis.7. CTPA （computed tomography pulmonary angiography, CTPA） in48patients found thatchanges in the pulmonary artery branches and/or filling defect, characterized by lower lobe47cases,40cases in the upper lobes. The middle of the29cases, the left lower lobe38cases, 32cases in the upper lobes.8. Thrombolysis treatment effective rate was71.4%, the anticoagulant treatment effective ratewas97.1%, generally handle is invalid. Thrombolysis group,5cases were complicated bybleeding, anticoagulant group of4cases were complicated by bleeding. Included5casesuyghur nationality drugs is slightly greater than the han nationality, INR standard time islong.Conclusions：Age>60years old, long-term smoking, cardiovascular disease,lower limb venousdisease, surgery,and obese patients should be regarded as high-risk groups and regular screeningof acute pulmonary embolism, early prevention of embolism in the occurrence and development.CTPA can be used as the first choice for the diagnosis of pulmonary embolism,such as D-dimer,blood gas analysis, ECHO can be used as auxiliary diagnosis means. Large areas of the patientswith acute pulmonary embolism treatment effectiveness is lower than the large area and time area.Thrombolysis and anticoagulation is effective treatment, and can significantly reduce themortality.Included5cases uyghur nationality drugs is slightly greater than the han nationality,INR standard time is longer.