Clinical Analysis Of 8 Cases With Pulmonary Embolism In Children

Objective: To research into the clinical characteristics and the therapeutic approach in children with PE(pulmonary embolism).Methods: The clinical data of 8 hospitalized children with PE diagnosed from March 2001 to October 2018 in Children's Hospital Affiliated to Chongqing Medical University were retrospectively analyzed.Results: Among the 8 cases with pulmonary embolism,3 cases were male and 5 cases were female,the age of subjects ranged from 7 months to 11.7 years old,the median age was 7.96 years old.All of which had underlying diseases,among them,congenital heart disease with infective endocarditis accounted for 37.5%.Among the 8 cases,4 cases presented with symptoms of respiratory tract infection,7 cases had shortness of breath,5 cases had cough,3 cases had chest pain,2 cases had hemoptysis,and 1 case had typical triad of pulmonary embolism with chest pain,dyspnea and hemoptysis.Among the 8 cases,7 cases of which did the arterial blood gas analysis and showed hypoxemia,6 cases of which did the D-dimer and the value>500ug/L,5 cases of which did the electrocardiogram and 4 cases of them showed sinus tachycardia,and 2 cases of them had ST-T changes,all of them did echocardiography and 3 cases of which indicated pulmonary artery excrescence,7 cases of which did spiral CT pulmonary angiography and 5 cases of them prompted pulmonary vascular filling defects,6 cases of which were embolized in the lower lobe of the lung.Three cases received anticoagulant therapy,1 case of them died.Two cases received thrombectomy,1 case of them died.Three cases were not treated with thrombectomy and anticoagulation therapy,2 cases of them died.Conclusion: The incidence of pulmonary embolism in children is low,but it is a potentially fatal condition requiring prompt diagnosis.The clinical manifestations of pulmonary embolism in children are not typical and difficult to distinguish from respiratory infections.In children,PE is characteristically seen in combination with serious underlying medical disorders.For children with high risk factors of pulmonary embolism,once clinical symptoms related to pulmonary embolism occur,D-dimer,echocardiography,and spiral CT pulmonary angiography should be done soon for early diagnosis and treat the disease.