Clinical Analysis Of Patients With Acute Pulmonary Embolism Risk Factors

ObjectiveTo analyze the clinical characteristics of various types of surgery-related pulmonary thromboembolism(PTE) in our hospital, described risk factors associated with pulmonary thromboembolism after surgery, in order to improve awareness and early diagnosis of postoperative clinicians the ability to prevent pulmonary embolism.MethodRetrospective analysis of hospitalized in general hospital of Ningxia Medical University from 2010 January to 2014 March treated 147 cases of postoperative pulmonary embolism clinical data.According to PESI(Pulmonary Embolism Severity Index) scores, the patients were divided into low risk group and high risk group. The relevant data were collected during the operation and after the operation, such as operation time, operation level, operation site, treatment, prognosis. According to various research element make the statistical analysis and discuss the results.Results1.In this study, patients with no significant gender differences. The average age of 57.2±12.87 years old. Number of cases in recent years are increasing year by year. Postoperative pulmonary embolism occurred in less than a week, common in orthopedic, gastrointestinal surgery, thoracic surgery.More difficult and risky for the 3,4-level surgery.2.In this study, patients with clinical manifestations of non-specific, feasible arterial blood gas analysis,ECG,UCG,chest X-ray and other tests provide evidence for clinically suspected pulmonary embolism.3. After analysis all of single factors during and after operation, we can draw surgical time, braking time, fibrinogen there are differences(P<0.05) in both groups, but other factors had no significant correlation. Included above factors into Logistic regression multivariate analysis. Found that compared to low-risk patients, the factors affecting high-risk group embolism are surgery time(OR=1.004 P<0.05) and braking time in bed(OR=0.896 P<0.05).Postoperative FIB in high-risk group is lower than the low-risk group(OR=1.438 P<0.05), suggesting that FIB can be used as indicators for monitoring high-risk group of pulmonary embolism.4.In this study only 30 cases received prophylaxis anticoagulation. And 145 cases received anticoagulation therapy. Among whom 27 cases were cured, 111 cases improved, 8 cases were ineffective, and 1 cases died after treatment, While 5 patients were discharged.Conclusion1.The low risk patients of the PESI score in the following circumstances shoud be more vigilant the occurrence of acute pulmonary embolism after the operation: a.the patients whose operation grade are 2 or 3; b.the patients whose operation site are head, pelvis, limbs, spine, bone marrow; c.the patients whose operation position are lie prostrate.2.Long operation time, Postoperative immobilization time, FIB level can be used as risk factor for monitoring high-risk groups of postoperative pulmonary embolism.