| 沈世茉,吴宏成,周莹艳,吴仕波,葛挺,陈伟庄.以晕厥为首发表现的肺栓塞患者肺栓塞严重指数及预后分析[J].浙江中西医结合杂志,2018,28(12): |
| 以晕厥为首发表现的肺栓塞患者肺栓塞严重指数及预后分析 |
| The Value Of PESI For The Prediction Of The Pulmonary Embolism Patients With Syncope As The First Symptom |
| 投稿时间：2017-08-28 修订日期：2018-10-29 |
| DOI： |
| 中文关键词: 肺栓塞，晕厥，预后 肺栓塞严重性指数 |
| 英文关键词:Pulmonary embolism Syncope prediction Thrombolytic therapy |
| 基金项目:宁波市医学科技计划项目 |
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| 中文摘要: |
| 目的 分析以晕厥为首发症状的肺栓塞患者肺栓塞严重指数（pulmonary embolism severity index, PESI）在肺栓塞预后中的意义。方法 收集宁波市李惠利医院2007年1月至2017年1月10年期间36例以晕厥为首发表现的急性肺栓塞患者的临床资料，并对其进行PESI评分及预后分析。结果 所收集的36例病例，咯血、呼吸困难、胸痛的发生分别为0/36，31/36，8/36，下肢静脉血栓和心超示右心功能不全或肺动脉高压的发生率为11/36，15/36，CTPA (computed tomographic pulmonary angiography, CTPA)示肺动脉主干或左右肺动脉干受累的发生是25/34,溶栓8/36。36例患者均行PESI评分，其中III级2例，IV级10例，IV级中2例复发，V级24例，V级中死亡3例。结论 晕厥肺栓塞患者进行PESI分级能反映肺栓塞的死亡风险，对肺栓塞预后有评估有指导作用。 |
| 英文摘要: |
| Objective To analyze the value of PESI for the pulmonary embolism with syncope as the first symptom．Methods Thirty-six patients of pulmonary embolism with syncope as the first symptom were collected during the past ten years in the Lihuili Hospital. Risk assessment was based on a validated clinical prognostic score as the PESI. ResuIts The occurence rate of hemoptysis, dyspnea and chest pain is 0/36, 31/36, 8/36 respectively; Eleven patients had DVT, while fifteen patients had hypotension or right venticula dysfunction on the echocardiography within all patients. Twenty-five of all thirty-six patients had embolism in the main or trunk pulmonary artery confirmed by CTPA and eight patients received thrombolytic therapy. All patients were evaluated by PESI Class, two patients in PESE Class III; ten in PESI Class IV with two patient recurrences; twenty-four patients in PESI Class V with three patients deaths. Conclusion PESI Class is useful for assessment of mortality risk and prognosis in PE patients with syncope as the first symptom. |
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