The Risk Factors And Clinical Analysis Of Prognosis Of Pulmonary Thromboembolism Disease

Objectives: According to the detailed analysis of the risk factors, clinicalmanifestation, laboratory examination methods and prognosis of pulmonarythromboembolism disease in this article, the understanding to this disease as well asdiagnosis level can be enhanced, further more, the cure rate can be improved, The rate ofmissed diagnosis and misdiagnosis can be reduced.Method:A retrospective analysis of the clinical data including88cases who werediagnosed as pulmonary thromboembolism admitted from October2009to April2012were performed in this article.Results:1. In our investigation, high-risk factors accompanied with pulmonaryembolism can be found in96.5%of patients. In the overall risk factors, the most commonones or underlying diseases were lower extremity deep vein thrombosis/the varicose(47.7%), followed by coronary heart disease (39.7%), hypertension (34.1%), infection(30.7%), COPD (22.7%), malignancy (18.1%), surgery (17%), diabetes (14.7%), fractures(12.5%). In addition to these,8cases with connective tissue disease (9%),7cases withhyperthyroidism (7.96%),2cases with bedridden (2.3%) were also included.2. The most common symptoms were dyspnea in61cases (69.3%), followed by chestpain in30patients (34.1%), cough (26cases,29.5%), hemoptysis in6cases (6.8%),syncope in2cases (2.3%).Remarkably, there were5patients accompanied by dyspnea,chest pain, hemoptysis (pulmonary infarction),accounting for5.7%. The most commonsigns of pulmonary embolism were pulmonary rales,22patients (25%), followed bypleural effusion in12patients (13.6%), cyanosis in11cases (12.5%), P2hyperfunction in10cases (11.4%), lower limbs swelling in10cases (11.4%), fever in7case (8.0%), theskin ecchymosis in1case (1.14%). 3. Auxiliary examination:(1) laboratory tests: D-dimer level≥500μg/L constituted75%(n=45) of60patients who underwent D-dimer test. In73patients who underwentblood gas analysis examination, of which arterial oxygen pressure value(PaO2) decreasedunder60mmHg in52patients (71.2%); arterial oxygen partial pressure value (PaCO2)decreased under35mmHg in50patients (68.4%);oxygen saturation (Sa02) was under95%in69cases (94.5%).24cases (80%) higher than normal in30patients who underwent ESRdetection.(2) ultrasound echocardiography: In50cases,pulmonary artery pressureincreased>35mmHg of62cases with PTE indirect signs, accounting for56.2%.In thepatients whose pulmonary artery pressure increased, mild pulmonary hypertension(36~50mmHg) included18cases, accounting for202%; moderate pulmonaryhypertension (50~70mmHg) included17cases, accounting for19.1%; severe pulmonaryhypertension (>70mmHg) included15cases, accounting for16.9%.(3) ECG: there weredifferent degree of changes in60cases’ECG, sinus tachycardia occurring in33patients(55%), ST-T change occurring in4patients (6.7%), S Ⅰ Q Ⅲ T Ⅲ occurring in18patients (30%), atrial fibrillation occurring in5patients (8.3%), right bundle branch blockoccurring in3patients (5%).(4) chest X-ray and lower extremity vascular ultrasound:X-ray chest showed pleural effusion in12patients (13.6). In the58PTE patients whounderwent lower extremity venous ultrasonography,60.3%(n=35) of them were foundvenous thrombosis.4. Treatment and prognosis: in the overall88patients,37cases were cured；22caseswere markedly effective；17cases were improved；1cases died,3cases are invalid.Conclusion: a variety of clinical manifestations, easily missed diagnosis andmisdiagnosis of pulmonary thromboembolism, made us have to enhance the awareness ofthis diaease. In order to reduce the mortality,it is necessary for us to perform earlyintervention.