【摘要】 目的 :探讨骨科手术后肺栓塞的诊断与治疗。方法 :从 1998年 6月～ 2 0 0 2年 4月共治疗骨科手术后肺栓塞 (PE) 5例 ,男 1例 ,女 4例。年龄 40～ 78岁 ,平均 6 3岁。手术类别 :人工股骨头置换术、人工全髋置换术、右肱骨外科颈骨折内固定术、右肱骨肿瘤切除术以及多发骨折内固定术各 1例。肺栓塞发生时间 3～ 14d ,平均 10d。诊断依据 :呼吸困难和气短、动脉血气PO2 下降和低碳酸血症、ECT 肺通气灌注静态显像异常等。治疗 :5例均行抗凝治疗 ,其中 3例行栓体舒 (t～PA)溶栓治疗。结果 :本组 5例中 3例诊断及时 ,行溶栓治疗后痊愈出院 ,2例抢救无效死亡。结论 :必须提高对肺栓塞的认识 ,才能早期发现、早期治疗、减少和避免严重后果。急性肺栓塞的治疗包括溶栓治疗、抗凝治疗、介入治疗和外科手术等。肺栓塞最好的治疗还是预防。特别是预防下肢深静脉血栓的发生至关重要。更多还原

【Abstract】 Objective:To discuss the diagnosis and treatment of pulmonary embolism following orthopaedic operation.Methods:Five cases pulmonary embolism following orthopaedic surgery were treated from June 1998 to April 2002,including 1 case male and 4 cases female.They were 40 to 78 years old,with an average of 63 years old.The orthopaedic operation were:replacement of femoral head,arthroplasty of total hip,internal fixation of fracture of surgical neck of humerus,tumor excision of humerus and internal fixation of multiple fracture.Pulmonary embolism occurred 3 to 14 days after surgery (main 10 days).The diagnosis basis were:dyspneic respiration,short breath,hypoxemia,hypocapnia and pulmonary ventilation-perfusion imbalance.All of these patients were performed anticoagulant therapy and three patients were used T-PA.Results:Three of the five patients recovered after anticoagulant therapy properly and the other patients died.Conclusion:Early discovery and treatment depended on knowledge of pulmonary embolism,which played a important role in decrease or avoid of bad result.The treatment of acute pulmonary embolism consisted of anticoagulant therapy,intervention treatment and surgical methods,and etc.But effective prevention was the best treatment,especially the prevention of lower extremity venous embolism was the most important measure.更多还原