【摘要】 目的　回顾性分析急性肺栓塞的临床及实验室检查特点 ,旨在早期诊断。方法　对无心肺基础疾病的以呼吸困难为主的、经高速螺旋CT及三维重建检查而诊断的 15例肺栓塞患者 ,对其临床及其他实验室检查进行回顾性分析。结果　突出的临床表现为呼吸困难、胸闷心悸 ;体症为呼吸急促、收缩期杂音、及心动过速。实验室检查主要是彩色多普勒超声心动图检查 ,部分病例在肺动脉内见到栓子 ,全部病例可见三尖瓣返流以及由此估测的肺动脉收缩压 ,肺动脉收缩压均高于正常 (4 2～ 76mmHg) ;血气分析显示PaO2 明显下降 (3 0～ 65mmHg)。结论　对突发的以呼吸困难、心悸等为主患者 ,在无高速螺旋CT设备时 ,彩色多普勒为首选检查方法 ,可根据其肺动脉压力的增高、右室扩大以及肺动脉的脉冲频谱特点作出明确的诊断而得到及时的治疗更多还原

【Abstract】 Objective To analyze the clinical and laboratory features of acute pulmonary embolism for diagnosis as possible as early.Methods For 15 patients of pulmonary embolism,who have not history of heart-lung disease and have been diagnosed by high speed multislice CT, the clinical and other laboratory data of these patients were retrospectively analyzed.Results The clinical manifestations were dyspnea ,chest distress, palpitation;the signs including tachypnea, systole murmur, tachycardia etc. The examinations were mainly color Dopple echocardiography and blood gas analysis. In some cases of embolism were found in their pulmonary artery; in all cases tricuspid regurgitation were found by color Dopple echocardiography and their pulmonary systole pressure were all over normal value(42～76mmHg).The blood gas analysis showed that PaO 2 was obviously lower than normal value(30～65mmHg).Conclusions The patient who has symptoms of dyspnea and palpitation must be examined by high speed multislice CT , color Dopple echocardiography and other measurements to get an immediate diagnosis . The first choice is color Dopple echocardiography when there is no high speed multislice CT. The patients can get exact diagnosis and prompt treatment by manifestation of pulse spectral of pulmonary artery, increase of pulmonary artery pressure, right ventricular enlargement.更多还原