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目的分析急性肺栓塞的临床特点,观察溶栓抗凝治疗对急性肺栓塞的临床治疗效果。方法通过对已确诊的23例急性肺栓塞患者进行有代表性的临床症状、体征和实验室及辅助检查分析;对其中16例行静脉溶栓加抗凝治疗,7例行单纯抗凝治疗,以临床及辅助检查评价治疗效果。结果23例病人均有肺栓塞危险因素。D-二聚体,血气分析,心电图,心脏彩超,X线胸片,肺CT等是诊断肺栓塞的综合指标;溶栓组有效率(93.8%)明显高于抗凝组(74.1%)(P<0.05)。结论应提高对急性肺栓塞的警惕性,及早诊断,减少误诊率;尿激酶溶栓加抗凝治疗优于单纯抗凝治疗。溶栓时间越早越好,对有溶栓适应症者应首选溶栓治疗。
Objective To analyze the clinical features of acute pulmonary embolism and observe the clinical effect of thrombolytic anticoagulation on acute pulmonary embolism. Methods A total of 23 patients with acute pulmonary embolism confirmed by clinical symptoms, signs and laboratory and laboratory examinations were analyzed; of which 16 cases were treated with intravenous thrombolysis plus anticoagulation, 7 cases were treated with anticoagulant therapy alone, Clinical and auxiliary examination to evaluate the treatment effect. Results All 23 patients had risk factors for pulmonary embolism. D-dimer, blood gas analysis, electrocardiogram, echocardiography, chest X-ray and pulmonary CT were the comprehensive indexes for diagnosis of pulmonary embolism. The effective rate of thrombolytic group (93.8%) was significantly higher than that of anticoagulation group (74.1%) P <0.05). Conclusions The vigilance of acute pulmonary embolism should be improved, early diagnosis and misdiagnosis rate should be improved. Urokinase thrombolytic therapy and anticoagulation therapy are superior to anticoagulation therapy alone. The sooner the better thrombolytic therapy, thrombolytic indications should be preferred thrombolytic therapy.