秘兴锋

【摘要】 目的 探索心脏超声联合下肢深静脉超声在肺血栓栓塞症（PTE）诊断中的应用价值。方法 60例接受超声检查明确诊断为肺血栓栓塞症患者， 对其心脏超声及下肢深静脉超声诊断相关资料做回顾性研究分析， 探究超声筛查对该病诊断明确的重要性。结果 心脏彩超：60例肺血栓栓塞症患者中右心增大52例， 肺动脉的主干及左右支有增宽表现28例， 肺动脉的主干内有等回声团2例， 分叉位置存在高回声4例， 肺动脉的右支内存在高回声4例， 左支中存在等回声2例；三尖瓣返流60例伴中度或者重度肺动脉有高压42例；下肢深静脉彩超：60例患者中均存在单侧或双侧的下肢深静脉血栓。结论 下肢深静脉超声及心脏超声联合应用可以准确显示疾病相关征象， 十分有益于该疾病的早期诊断与治疗， 故在肺血栓栓塞症的诊断过程中， 有着较高的的临床及社会价值。

【关键词】 心脏超声；下肢深静脉超声；肺血栓栓塞症；应用价值

DOI：10.14163/j.cnki.11-5547/r.2017.08.021

【Abstract】 Objective To investigate application value of cardiac ultrasound combined with lower extremity deep vein ultrasound in diagnosis of pulmonary thromboembolism （PTE）. Methods A retrospective analysis was made on clinical data of cardiac ultrasound and lower extremity deep vein ultrasound in 60 patients with confirmed pulmonary thromboembolism by ultrasound examination. Importance of ultrasound screening for disease diagnosis was investigated. Results Cardiac ultrasound showed 52 cases with right cardiac enlargement， 28 cases with main and collateral pulmonary artery broadening， 2 cases with hypoechoic mass in main pulmonary artery， 4 cases with high level echo in furcation， 4 cases with high level echo in right collateral pulmonary artery， 3 cases with equal echo in left collateral pulmonary artery， 60 cases with tricuspid regurgitation， and 42 cases with complicated moderate or severe pulmonary arterial hypertension among the 60 patients. Lower extremity deep vein ultrasound showed all 60 cases with unilateral or bilateral deep venous thrombosis. Conclusion Combination of lower extremity deep vein ultrasound and cardiac ultrasound can accurately reveal disease-related symptom， and it is beneficial for early diagnosis and treatment for disease. Therefore， this method contains highly clinical and social value in diagnosis of pulmonary thromboembolism.

【Key words】 Cardiac ultrasound； Lower extremity deep vein ultrasound； Pulmonary thromboembolism； Application value

肺栓塞是因为内源性或外源性的各种栓子阻塞肺动脉或其分支造成的一系列呼吸或肺循环功能障碍的综合病症， 而肺血栓栓塞是肺栓塞中的常见类型之一， 其根源为来自静脉或右心的血栓栓子阻塞肺动脉继而造成的呼吸及肺循环障碍， 其血栓主要源于下肢深静脉， 所以深静脉血栓形成（DVT）与肺血栓栓塞实质上是一种疾病的不同部位、不同阶段的不同表现， 早期深静脉血栓形成多数没有明显症状， 晚期肺血栓栓塞才表现出症状， 所以临床上如果单纯依靠症状诊断则容易存在诸多治疗的延误， 因为肺血栓栓塞的临床致残致死率较高。……