【摘要】 目的探讨和比较心电图(ECG)、动脉血气分析、D-二聚体和超声心动图(UCG))4种常规检查手段对肺栓塞(PE)的辅助诊断价值。方法回顾性分析我院收治的90例经肺通气/灌注扫描和(或)肺动脉CT成像(CTPA)明确诊断的非大面积肺栓塞病例,以超声心动检查结果将其分为A组(次大面积肺栓塞组)和B组(非次大面积肺栓塞组),通过对其ECG有无肺栓塞的典型表现、动脉血氧分压(PaO2)、D-二聚体和UCG测定的肺动脉收缩压(PASP)的大小等进行比较分析和评价。结果4种不同辅助检查手段对肺栓塞诊断的敏感度从高到低依次为:D-二聚体、血气分析、UCG和ECG。除ECG无定量分析外,本研究结果表明,D-二聚体在A、B组间差异无统计学意义;PaO2和PASP在A、B组间差异有统计学意义(P<0.05或<0.01)。结论4种检查手段从不同的方面反映出肺栓塞时的病生理变化,是对急性肺栓塞进行早期筛查和辅助诊断的有力武器,尤其适用于门诊及急诊医生。更多还原

【Abstract】 Objective To investigate and compare the diagnostic value of four general examination methods(electrocardiogram,arterial blood gas analysis,D-dimer and ultrasonic cardiogram) on pulmonary embolism(PE).Methods Retrospective analysis was 90 cases of non-large area PE diagnosed by pulmonary ventilation /perfusion scan and(or) CT pulmonary angiography(CTPA) in the hospital.Based on ultrasonic cardiogram results,all cases were divided into group A(hypo-large area PE group) and group B(non-large area PE group) to compare,analyze and evaluate typical signs of PE shown on electrocardiogram(ECG),if any,partial pressure of oxygen(PaO2),D-dimer and pulmonary artery systolic pressure(PASP) measured by ultrasonic cardiogram(UCG).Results The sensitivities of four diagnostic examination methods on PE,from high to low,were as follows:D-dimer,blood gas analysis,UCG and ECG.The results of this investigation except ECG,which did not have quantitative analysis,showed that there was no significant difference between the extent of D-dimer increase and the severity of PE in group A and group B,PaO2 and PASP had significant difference in group A and group B.Conclusion These four examination methods,which reflect pathophysiologic changes of PE from different aspects,are very helpful for early screening and diagnosis of acute PE,especially useful for doctors in out-patient and emergency departments.更多还原