本文選題：肺栓塞 + 抗凝�。� 參考：《山西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的 評(píng)價(jià)肺栓塞(pulmonaryembolism,PE)患者抗凝治療3月的臨床療效，探討PE抗凝治療的療程。 方法 采用描述性研究的方法對(duì)山西醫(yī)科大學(xué)第一醫(yī)院呼吸科2011年8月至2012年6月收治的住院初診PE患者進(jìn)行研究。研究期間共收治65例PE，其中資料完整的32例納入研究。所有患者符合中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)2001年制定的《肺血栓栓塞癥的診斷與治療指南》（簡(jiǎn)稱指南）的診斷標(biāo)準(zhǔn)，經(jīng)核素肺通氣/灌注掃描（V/Q）、螺旋CT肺動(dòng)脈造影(CTPA)中至少一項(xiàng)檢查確診，，根據(jù)指南標(biāo)準(zhǔn)劃分大面積與非大面PE。觀察這些患者經(jīng)規(guī)范化抗凝治療3月后的臨床表現(xiàn)及輔助檢查情況，并與發(fā)病時(shí)的情況進(jìn)行對(duì)比。 結(jié)果 32例患者治療前后呼吸困難分別為84.38%及37.5％，咳嗽為43.75％及6.25％，下肢腫脹為40.63％及9.38%，胸痛為28.13％及3.13%。30例心電圖SⅠ、QⅢ和/或TⅢ陽(yáng)性者治療前后分別為43.33％及6.67%，非特異性ST-T異常者治療前后分別為63.33％及20.00％。28例超聲心動(dòng)圖檢查治療前后肺動(dòng)脈高壓分別為71.43％及25.00％，右室擴(kuò)大分別為78.57％及64.29％。30例治療前后下肢深靜脈存在血栓分別為87.50％及26.67％。32例治療前后CTPA肺動(dòng)脈內(nèi)充盈缺損分別為87.50％及21.88％；14例治療前后V/Q肺灌注缺損分別為71.43％及21.43％。右室擴(kuò)大治療前后差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）,其余各指標(biāo)治療前后差異均有統(tǒng)計(jì)學(xué)意義（均P0.05）。 結(jié)論 經(jīng)規(guī)范化抗凝治療3個(gè)月，PE患者的臨床表現(xiàn)及輔助檢查顯著改善，但CTPA、V/Q和/或DVT多數(shù)仍存在異常，故應(yīng)經(jīng)過(guò)臨床評(píng)估決策抗凝治療的療程。
[Abstract]:Purpose Objective: to evaluate the clinical effect of anticoagulant therapy for 3 months in patients with pulmonary embolism (PE) and to explore the course of PE anticoagulant therapy. Method A descriptive study was conducted on PE patients admitted to the Department of Respiratory in the first Hospital of Shanxi Medical University from August 2011 to June 2012. A total of 65 cases of PEI were treated during the study, of which 32 cases with complete data were included in the study. All patients met the diagnostic criteria of the guidelines for the diagnosis and treatment of Pulmonary Thromboembolism (abbreviated as the guidelines) developed by the Chinese Medical Association Respiratory Society in 2001. The diagnosis was confirmed by at least one examination in radionuclide pulmonary ventilation / perfusion scanning (V / Q) and spiral CT pulmonary arteriography (CTPA). According to the criteria of the guidelines, large and non-large area PEs were divided. The clinical manifestations and adjuvant examination of these patients after 3 months of standardized anticoagulant therapy were observed and compared with those at the time of onset. Result 32 patients with dyspnea were 84.38% and 37.5% before and after treatment, 43.75% and 6.25% with cough, 40.63% and 9.38 with lower limb swelling, 28.13% with chest pain and 3.13.30 cases with positive S 鈪

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