Clinical analysis of 45 cases of acute pulmonary embolism

Objective To discuss and summarize the predisposing factors, clinical features and treatment methods of acute pulmonary embolism, thus to improve the understanding of acute pulmonary embolism. Methods The predisposing factors, clinical manifestations, diagnosis, treatment and prognosis of 45 cases diagnosed as acute pulmonary embolism were analyzed retrospectively from January, 2010 to December, 2016 in the first people's hospital of Bengbu. Results The clinical diagnosis of acute pulmonary embolism in 45 patients included 23 cases of male, 22 cases of female. The age of the patients ranged from 34 to 88 years, with an average age of (69. 00 ±12. 79) years, including 36 cases of internal medicine (80%), surgical patients in 9 cases (20%). The clinical manifestations were chest tightness (n=38), anhelation (n=20), shock (n=12), cough (n=10), dyspnea (n=10), chest pain (n=7), palpitations (n=7), hemoptysis (n=2), and syncope (n=1). Thirty cases had more than 2 symptoms at the same time. The risk factors were as follows:venous thrombosis of lower limbs or lower extremity varicose veins, cardiovascular and cerebrovascular diseases, fracture or fracture surgery, smoking, staying in bed for more than 3 days, diabetes and chronic obstructive pulmonary disease. In this group of patients, 39 cases were diagnosed by CTPA as pulmonary thromboembolism, 1 case was diagnosed by echocardiography, 1 case was diagnosed by surgical thrombectomy, and 4 critical condition cases were diagnosed by clinical comprehensive analysis. The positive rate of D-dimer was 93%. Electrocardiogram, echocardiography, lower limb venous ultrasonography and blood gas analysis had certain specific changes. Six cases died due to invalid rescue, one case was treated with thrombolytic therapy remain unconscious, the others were treated with thrombolytic or anticoagulant therapy, and the clinical symptoms were improved obviously. Conclusion Acute pulmonary embolism lacks specific symptoms and signs. Incidence of the disease is closely related to the susceptible factors. Thrombolysis and anticoagulation therapy can improve the survival rate in patients with acute pulmonary embolism.