Pulmonary Embolism In Patients With Traumatic Skin Defects And Its Influencing Factors

Objective:Pulmonary embolism(PE)is a general term for a group of diseases caused by various emboli obstructing the pulmonary arteries.Its main clinical and pathophysiological characteristics are pulmonary circulation and respiratory dysfunction.Pulmonary thrombosis,fat,amniotic fluid,and air are common in emboli causing pulmonary embolism.Because of its higher lethality,PE should be highly alert in clinical practice.At present,there is no clinical non-invasive examination that can simultaneously take into account the specificity and sensitivity of early diagnosis of PE.Therefore,the rate of misdiagnosis and misdiagnosis of PE in clinical work is relatively high.In patients with post-traumatic skin defects,PE is the most serious clinical complication.Although the incidence of post-traumatic skin defect associated with PE is not high,due to its high mortality rate,the study of its risk factors and early diagnosis and treatment has important clinical significance.Retrospective analysis of PE patients with traumatic skin defect,and to explore its early diagnosis and treatment methods,risk factors and prevention methods.Methods:The clinical data of PE patients who were hospitalized after traumatic skin defect were collected from January 2011 to July 2017 in the Department of Burn and Plastic Surgery,Nanjing Drum Tower Hospital.All patients were confirmed by spiral CT pulmonary angiography(CTPA),both unilateral or bilateral pulmonary embolism with branch embolism.Statistics and analysis of patients age,gender,admission time,traumatic causes,wound infection,plasma D-dimer,surgical conditions,screening patients with PE risk factors,to explore the early diagnosis and treatment of PE and prevention methods.Results:All 5 patients recovered well after prompt treatment.Pulmonary artery and branches of the original pulmonary lesions had restored blood supply and the blood supply area was evenly distributed.Five patients included 4 males and 1 female;aged 26 to 68 years and mean age 46.8 years;skin defects after trauma were caused by trauma and extensive skin contusion;PE was found at 4 to 46 days after admission,with an average of 23.2 days.The bed rest time before PE was 4 to 46 days,with an average of 23.2 days.Among them,4 patients were found to have PE time after surgery(average 20.5 d from 14 to 40 days after surgery).All 5 patients had infections on their wounds.Laboratory tests showed that D-dimer increased(2.4 to 31.67 mg/L,mean 12.76 mg/L).Conclusions:20 days after injury healed,bed time>20d,have surgery in the hospital,aged>40 years,with wound infection,D-dimer detection value ?5.0 mg/L in patients with traumatic skin defect may occur PE,these patients should attach great importance to the concurrent PE,in response to different situations in a timely manner to deal with.