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find Keyword "肺血栓栓塞症" 12 results
  • The value of different imageology methods in the diagnosis of acute pulmonary embolism

    Objective To investigate the value of different imageology methods in the diagnosis of acute pulmonary thromboembolism (PTE).Methods 22 cases diagnosed acute PTE in the last two years were retrospectively analysed,including 4 cases diagnosed by clinical signs and symptoms who did not perform further examinations due to severity of the disease (2 cases confirmed by autopsy),18 cases diagnosed by either two methods of computed tomographic pulmonary angiography (CTPA),ultrasound,radioisotope scanning of lung and pulmonary arteriography.The diagnostic positive rate of different methods were measured.Results 15 of the 18 subjects were performed CTPA,with a positive rate of 80.0% (12/15).Nuclide detection was performed in 14 cases,in which 5 cases were performed simple pulmonary infusion scanning,9 cases by lung ventilation/perfusion scanning,resulted in a positive rate of 92.9% (13/14).10 cases were performed nuclide phlebography on the low extremity simultaneously,deep phlebothrombosis was found in 5 subjects,and unnormal formation of collateral circulation,blocked blood circulation,stenosis of lumens,and valve disfunction et al were found in other 5 cases.16 cases were performed heart color ultrasound detection,in which 2 were found normal,one was directly found thrombus,and the other 8 cases were found indirect manifestations of acute PTE,including right ventricular enlargement,pulmonary artery hypertension,tricuspid backstreaming et al,with a diagnosing rate of 56% (9/16).Deep phlebothrombosis was found in 6 of the 10 cases who were performed color Doppler ultrasonography on the lower extremity,and one was found with valve function impaired.Conclusions CTPA possesses high positive rate in diagnosing acute PTE with promptness,convenience and reliability,thus can be taken as the front-line detection device.Radioisotope scanning of lung associated with same-time phlebography on the low extremity also has fairly high positive rate to diagnosing acute PTE and make it easy.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • Comparative Study on the Efficacy and Safety of Thrombolysis and Anticoagulation Therapy for Patients with Acute Sub-Massive Pulmonary Thromboembolism

    Objective To compare the clinical efficacy and safety of thrombolysis with anticoagulation therapy for patients with acute sub-massive pulmonary thromboembolism. Methods The clinical data of 84 patients with acute sub-massive pulmonary thromboembolism were analyzed retrospectively, mainly focusing on the in-hospital efficacy and safety of thrombolysis and/ or anticoagulation. The efficacy was evaluated based on 6 grades: cured, markedly improved, improved, not changed, deteriorated and died. Results Among the 84 patients,49 patients received thrombolysis and sequential anticoagulation therapy( thrombolysis group) , 35 patients received anticoagulation therapy alone( anticoagulation group) . As compared with the anticoagulation group, the thrombolysis group had higher effective rate( defined as patients who were cured, markedly improved or improved, 81. 6% versus 54. 3%, P = 0. 007) , lower critical event occurrence ( defined as clinical condition deteriorated or died, 2. 0% versus 14. 3% , P = 0. 032) . There was no significant difference in bleeding rates between the two groups ( thrombolysis group 20. 4% versus anticoagulation group 14. 3% , P gt; 0. 05) . No major bleeding or intracranial hemorrhage occurred in any of the patients. Conclusions Thrombolysis therapy may be more effective than anticoagulation therapy alone in patients with acute sub-massive pulmonary thromboembolism, and thus warrants further prospective randomized control study in large population.

    Release date:2016-09-14 11:22 Export PDF Favorites Scan
  • Pulmonologists Play an Important Role in the Diagnosis of Pulmonary Thromboembolism

    Objective Pulmonary thromboembolism ( PTE) is associated with various risk factors which existed in multidisciplinary patients. It is necessary to know what the role of pulmonologists in the diagnosis of PTE. Methods Data were collected from thirteen general hospitals in Guangxi. Hospital records of PTE cases from1995 to 2007 were retrospectively analyzed. The rates of PTE to inpatients between the respiratory departments and other departments or between different periods were compared. Results The rates of PTE of inpatients in respiratory departments ( 1. 55‰, 170/109 577) was higher than that in other departments ( 0. 03‰, 69/2 322 944) , P lt; 0. 001. Compared to that of 1995-2001, the rate of PTE of inpatients in the respiratory departments in the last 6 years increased by 3220. 22% [ ( 2. 43‰,167/68 638) vs ( 0. 07‰, 3 /40 939) ] . During 1995-2001 and 2002-2007, the rates of PTE of inpatients in the respiratory departments were higher than those in other departments [ 0. 004‰ ( 4/1 012 830) during 1995-2001 and 0. 05‰( 65 /1 310 114) during 2002-2007, respectively] , P lt; 0. 01. Conclusion pulmonologists play an important role in the diagnosis of PTE in the recent years.

    Release date:2016-09-14 11:24 Export PDF Favorites Scan
  • Clinical Features and Management of OSAHS Patients Complicated with Pulmonary Thromboembolism

    Objective To invesitgate the prevalence of pulmonary thromboembolism (PTE) in hospitalized patients with obstructive sleep apnea-hypopnea syndrome (OSAHS)from January 2004 to December 2008,and analyse its impact on the severity of OSAHS. Methods Demographic and clinical characteristics of 24 OSAHS patients complicated with PTE were analyzed. 30 OSAHS patients without PTE were served as controls. Results PTE was detected in 2.44% (31/1268) of the OSAHS patients. When compared with the OSAHS patients without PTE,the OSAHS patients with PTE had a significantly higher apnea hypopnea index (AHI) [(27.8±11.6)/h vs. (18.2±8.1)/h,P=0.038] and a lower LSpO2 (lowest saturated pulse arterial oxygen level) [(78.4±8.5)% vs. (85.2±7.9)%,P=0.035]. Both groups received continuous positive airway pressure (CPAP) ventilation. Anticoagulation and/or thrombolysis treatment were used in the OSAHS patients with PTE. Conclusions We found a higher prevalence of PTE in patients with OSAHS. Compared with those without PTE,OSAHS patients with PTE have more severe sleep apnea-hypopnea and hypoxemia in sleep. Comprehensive treatments including anticoagulation and CPAP should be used in these patients.

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • Analysis on Risk Factors of 516 Patients with Pulmonary Thromboembolism in Uyghur and Han Nationalities

    Objective To analyze the risk factors and clinical characteristics of patients in Uyghur and Han nationalities with pulmonary thromboembolism (PTE), who were hospitalized in past 7 years in the First Affiliated Hospital of Xinjiang Medical University, so as to investigate differences of risk factors between two nationalities. Methods Through retrospective study, clinical characteristics of PTE patients hospitalized from 2004 to 2010 were analyzed. T-test and chi-square test were used to conduct statistic analysis. Results a) A total of 516 patients (mean age 58.7±14.8 years old) with complete clinical materials were included, of whom 360 were Han nationality (69.8%, mean age 63.5±15.5 years old) and 156 were Uyghur nationality (30.2%, mean age 52.8±14.3 years old). In Han nationality, the peak age of PTE onset was above 70 years of age, while in Uyghur nationality it was 60 to 69 years of age; b) No significant difference was found in the clinical characteristics between the two nationalities; and c) The commonly acquired risk factors for PET patients in both nationalities possibly were age at or over 40 years old, obesity, embolism history and hyperlipidemia. The main risk factor of PTE was obesity in Uyghur nationality, while that was smoking in Han nationality. Conclusion The most common acquired risk factors and basic diseases of PTE patients are probably the age at or over 40 years old, obesity, embolism history and hyperlipidemia, and obesity is commonly seen in Uyghur nationality. A large number of further case-control studies are needed to further confirm this conclusion.

    Release date:2016-09-07 10:59 Export PDF Favorites Scan
  • 血栓试验联合CT对急性肺血栓栓塞症早期诊断价值研究

    【摘要】 目的 总结血栓试验联合16层螺旋CT检查在急性肺血栓栓塞症早期诊断中的应用价值。 方法 将2008年3月—2010年3月收治的疑似肺血栓患者60例,及选取的20例健康人员分为两组,每组40例,疑似患者与健康者均为3∶1,进行检查准确性的验证。对照组采用血栓试验进行检查,观察组采用血栓试验结合CT检查,对两组患者的准确率、诊断敏感性、特异性、阳性预测值、阴性预测值、诊断指数及可用度等数据进行比较。 结果 对照组的准确率为67.5%,观察组准确率为90.0%,两组差异有统计学意义(χ2=6.050,P=0.014)。CT肺动脉造影可以清楚显示血栓部位、形态、与管壁的关系及内腔受损状。 结论 血栓试验联合螺旋CT检查在急性肺血栓栓塞症早期的诊断中具有重要价值。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Clinical Feature Analysis of Obstructive Sleep Apnea-hypopnea Syndrome with Pulmonary Embolism

    ObjectiveTo observe the impact of obstructive sleep apnea-hyponea syndrome (OSAHS) on the severity of pulmonary thromboembolism (PTE) and its treatment strategies. MethodsPTE patients hospitalized in our department between January 2006 and December 2012 were screened for this study, including 16 patients with OSAHS and 20 patients without OSAHS, and the difference in clinical characteristics such as arterial blood gas, apnea-hypopnea index, lowest pulse oxygen saturation (LSpO2) and treatment methods were analyzed and compared between the two groups. ResultsAs compared to PTE patients without OSAHS, the age of patients was lower[(53.4±12.1), (64.5±9.8) years; P=0.005], while body mass index[(29.3±2.2), (26.1±3.3) kg/m2, P=0.002] and smoking index (150±24, 101±18; P<0.001) were higher in PTE patients with OSAHS. Additionally, significantly lower LSpO2[(71.7±8.3), (79.4±7.1) mm Hg (1 mm Hg=0.133 kPa); P=0.005] and more lung segments (8±3, 5±2; P=0.001) were involved in PTE patients with OSAHS. In this cohort, all patients received anticoagulation and/or thrombolysis treatment, but the rate of continuous positive airway pressure (CPAP) ventilation application was significantly higher in PTE patients with OSAHS. ConclusionPTE patients with OSAHS have relatively lower age but serious condition, and both anticoagulation and CPAP should be used in the clinical treatment.

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  • Study on the correlation between INR and the activity of coagulation factor II and X in patients with pulmonary thromboembolism with moderate and low intensity anticoagulation by oral warfarin

    ObjectiveTo study the correlation between international normalized ratio (INR) and coagulation factor Ⅱ and Ⅹ in patients with pulmonary thromboembolism treated with warfarin at moderate and low intensity anticoagulation.MethodsFifty-one patients with pulmonary thromboembolism treated with warfarin orally were divided into low-intensity anticoagulation group (INR from 1.6 to 2.0) and standard-intensity anticoagulation group (INR form 2.0 to 3.0) according to their monitoring INR indices. The levels of coagulation factor Ⅱ and Ⅹ were measured, and the correlation between INR level and coagulation factor activity was compared.ResultsThe INR of the low intensity anticoagulation group was 1.69±0.2 and the standard intensity anticoagulation group was 2.55±0.46. The corresponding activity of coagulation factor Ⅱ was (48.3±28.0)% and (24.0±8.0)% respectively. The activity of coagulation factor Ⅹ was (32.8±24.0)% and (16.7±6.0)%. There was a negative correlation between the activity of INR and coagulation factor Ⅱ and Ⅹ, with correlation coefficients of –0.903 and –0.459, respectively. Coagulation factor Ⅱ activity < 40%, coagulation factor Ⅹ activity inhibitory level < 25% is defined as anticoagulation effect. When coagulation factor Ⅱ activity level reaches anticoagulation effect, the corresponding minimum INR value was 1.56 and as to coagulation factor Ⅹ, the corresponding minimum INR value was 1.66.ConclusionsINR is negatively correlated with the activity of coagulation factor Ⅱ and coagulation factor Ⅹ. With the increase of INR, the activity of coagulation factor Ⅱ and coagulation factor Ⅹ decrease. Low intensity anticoagulation could not effectively inhibit the activity of coagulation factor.

    Release date:2020-09-27 06:38 Export PDF Favorites Scan
  • 肺血栓栓塞症合并下肢深静脉血栓临床分析

    目的探讨肺血栓栓塞症患者合并下肢深静脉血栓(DVT)临床特征。方法对 2009 年 1 月至 2018 年 5 月北京医院收治的 343 例急性肺血栓栓塞症(PTE)患者的临床资料进行回顾性分析,根据合并下肢 DVT 情况分为近端 DVT 组、单纯下肢远端 DVT(IDDVT)组和无 DVT 组。比较各组临床特征及预后情况。结果343 例 PTE 患者平均(68.2±13.0)岁,男 165 例(48.1%)。158 例(46.1%)合并 DVT,其中下肢近端 DVT 91 例(57.6%),IDDVT 67 例(42.4%)。伴下肢 DVT 相关症状者 137 例(39.9%)中,检出 DVT 79 例(57.7%)。近端 DVT 组伴 DVT 相关症状的比例显著高于另两组(P=0.002 和 P<0.001)。近端 DVT 和 IDDVT 组白细胞及 D-二聚体水平显著高于非 DVT 组(均 P<0.05)。近端 DVT 组溶栓、置入下腔静脉滤器的比例均显著高于非 DVT 组(均 P<0.05),近端 DVT 组及 IDDVT 组低危 PTE 的比例显著低于无 DVT 组(P=0.042 和 P=0.013)。三组住院病死率差异无统计学意义(均 P>0.05)。多因素 Logistic 回归分析显示,目前吸烟(OR=2.96,95%CI 1.44~6.09,P=0.003)、DVT 病史(OR=2.27,95%CI 1.09~4.70,P=0.028)、DVT 症状(OR=3.26,95%CI 1.86~5.69,P<0.001)、D-二聚体>500 ng/mL(OR=4.47,95%CI 2.25~8.86,P<0.001)是 PTE 患者合并近端 DVT 的独立危险因素。DVT 病史(OR=7.27,95%CI 2.87~18.43,P<0.001)、脑血管病(OR=2.49,95%CI 1.07~5.76,P=0.033)、D-二聚体>500 ng/mL(OR=2.50,95%CI 1.30~4.82,P=0.006)是 PTE 患者合并 IDDVT 的独立危险因素。结论急性 PTE 患者伴发下肢 DVT 的比例接近 50%,其中超过一半为下肢近端 DVT。依据临床症状诊断 DVT 的可靠性较低,DVT 病史和 D-二聚体>500 pg/mL 是 PTE 患者合并下肢近端和远端 DVT 的独立危险因素。

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  • Analysis of risk factors for the prediction of short-term adverse event associated with acute non-high-risk pulmonary embolism

    Objective To evaluate the prognostic value of several indexes of laboratory and ultrasonic cardiogram for adverse events in 3 months following the diagnosis of acute non-high-risk pulmonary embolism. Methods A total of 266 cases of acute non-high-risk pulmonary embolism patients diagnosed and treated in Beijing Anzhen Hospital during 2016 to 2017 were retrospectively analyzed. The patients were divided into a bad event group and a control group according to whether there was a bad event happened in 3 months following the diagnosis. The general data, indexes of laboratory and ultrasonic cardiogram were compared. Univariate and multivariate COX regression analysis were conducted to explore independent risk factors for 3 months’ poor prognosis. Results The bad outcome group had a significantly higher value of the proportion of suffering from connective disease and active cancer, C-reaction protein, monocyte/lymphocyte ratio (MLR) and urea while a significantly lower level of red blood cell count and hemoglobin compared with the control group (all P<0.05). Univariate and multivariate COX regression analysis showed that both the MLR (hazard ratio 14.59, 95% confidence interval 1.48 - 143.69, P=0.02) and suffering from connective disease (hazard ratio 5.85, 95% confidence interval 1.11 - 30.81, P=0.04) remain significantly different between the bad events group and the control group. Conclusion MLR at the admission may be related to the 3 months death of acute non-high-risk pulmonary embolism.

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