PE的治疗除一般治疗外,积极溶栓及抗凝治疗是成功的关键。溶栓治疗[14] 可迅速溶解血栓和恢复肺组织再灌注,逆转右心衰竭,改善肺毛细血管容量及降低病死率和复发率。有效率在80%以上。同时溶解外周静脉血栓,降低PE的复发率[1];抗凝治疗[15]可防止栓塞发展和再发,病人心功能获得改善[1]。有建议临床可疑肺栓塞时即可进行有效的抗凝治疗[16]。本组15例(88%)住院期间存活的病人治疗后心功能均改善,呼吸困难、胸闷等症状基本缓解。
综上所述,PE临床表现无特异性,极易造成误诊,目前随着临床医师对PE的诊断意识的提高,结合相应必备的检查设备的完善,有针对性地进行特异性检查,及时正确治疗,PE的漏诊率和误诊率、病死率将会不断降低。
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