Analysis Of Risk Factors And Clinical Features Of107Cases With Acute Pulmonary Thromboembolism

Objective To analyse the clinical feature of pulmonary thromboembolism (PTE),such as risk factors, symptom and so on. And to approach the methods of diagnoseand treatment. Therefore we can decrease misdiagnosis rate and missed rate.Methods Data of hospitalization patients with PTE in Fujian provincial hospitalfrom January2007to June2011were analyzed retrospectively, including generalinformation, risk factors, clinical manifestation, laboratory data, imageology data,risk degree of pathogenetic condition, treatment, and turnover. The frequency of thedata was calculated.Results①The age span of PTE incidence concentrated on70～79（32.71%）, theage span of60～69（28.04%）和50～59（22.43%）followed.②The dangerous factorsof PTE mainly included advanced age（62.62%）, malignant tumor（16.82%）,operation（14.02%）, stroke（13.08%）and smoking（12.15%）.③Dyspnea was themost common symptom in PTE, and right ventricular failure was the most commonsign in PTE.④83.33%of the patients showed drop of arterial partial pressure ofoxygen（PaO2）.100%of the patients showed positive in D-dimer（D-D）.31.25%ofthe patients showed positive in cardiac troponin I （cTnI）.8.82%of the patients hadimprovement in SIQIIITIII，2.94%of the patients had improvement in right bundlebranch block，5.88%of the patients had improvement in lung type P wave，14.71%ofthe patients had improvement in clockwise rotation and26.47%of the patients hadimprovement in T wave and ST segment of V1-V4leads.39.24%of the patients hadright ventricular enlargement,48.10%had pulmonary hypertension（PH）, and34.18%had both right ventricular enlargement and the increase of pulmonary arterial pressure.The most possible blocking positions were the bilateral pulmonary artery andbranches（73.83%）, the next were the artery and branches of inferior lobe of rightlung（9.35%）and artery of right lung（8.41%）.58.82%of the patients revealed venous thrombosis（VT）of the lower extremity.⑤The effective rate of thrombolysis＆anticoagulantion was91.30%, and the effective rate of simple anticoagulantion was100%. There was no significance difference by comparison of items above (P<0.05).Conclusion①The ratio of advanced age was higher than that of younger patientsin PTE.②The majority of PTE patients could find risk factors. Elderly, malignanttumor, operation, stroke, smoking, chronic venous diseases, chronic heart failure,acute myocardial infarction, brake, trauma and blood system diseases were commonrisk factors, which had important significance for PTE diagnosis.③Clinicalsymptoms of PTE were complex and changeful, but dyspnea, chest pain, cough werethe chief symptoms. The risk factors combined with clinical symptoms could estimatethe clinical possibility of PTE which could reduce the misdiagnosis and misseddiagnosis.④Computed tomography pulmonary angiography（CTPA）was muchfaster, simpler and less traumatic than pulmonary angiography, so CTPA was thepreferred method of confirming PTE. Clinicians needed to diagnose the high-riskpatients according to the procedure which included suspected consultations andcomfirmed approaches in order to improve early accurate diagnosis rate.