【摘要】 目的探讨急性肺栓塞合并肺动脉高压患者的诊治情况,为临床提供参考。方法选取2013年1月至2018年2月该院收治的急性肺栓塞合并肺动脉高压患者112例,采用回顾性方法分析临床资料。结果 112例患者中,合并下肢深静脉血栓(DVT)病史者44例,恶性肿瘤18例;主要为其他非典型临床表现;其中79例患者予以单纯抗凝治疗。D-二聚体检查阳性率为89.29%;CT肺动脉造影(CTPA)检查阳性率为96.43%。治疗后,72例患者病情好转,20例明确诊断为慢性血栓栓塞性肺动脉高压(CTEPH)。结论急性肺栓塞好发于高龄、合并DVT病史、恶性肿瘤患者。D-二聚体阴性不能完全排除急性肺栓塞。CTPA为目前诊断急性肺栓塞最常用且灵敏度较高的检查方法。规律有效地抗凝是治疗肺栓塞及预防CTEPH最基本的方法,防止肺栓塞反复发生可降低CTEPH的发生率。更多还原

【Abstract】 Objective To explore the diagnosis and treatment of acute pulmonary embolism with pulmonary hypertension,and to provide reference for clinical practice.Methods 112 patients with acute pulmonary embolism and pulmonary hypertension admitted to our hospital from January 2013 to February 2018 were selected for retrospective analysis of clinical data.Results Among 112 patients,44 had history of deep venous thrombosis(DVT)of lower extremity and 18 had malignant tumors,which were mainly other atypical clinical manifestations.79 of them were treated with anticoagulation alone.The positive rate of D-dimer was89.29% and that of CT pulmonary angiography(CTPA)was 96.43%.After treatment,72 patients improved and 20 patients were diagnosed as chronic thromboembolic pulmonary hypertension(CTEPH).Conclusion Acute pulmonary embolism is predominant in elderly patients with DVT history and malignant tumors.Acute pulmonary embolism cannot be completely ruled out by negative Ddimer.CTPA is the most commonly used and sensitive method for the diagnosis of acute pulmonary embolism.Regular and effective anticoagulation is the most basic method to treat pulmonary embolism and prevent CTEPH.Preventing the recurrence of pulmonary embolism can reduce the incidence of CTEPH.更多还原