Pessinaba Soulemane, Atti Yaovi Dodzi Molba, Baragou Soodougoua, Pio Machihude, Afassinou Yaovi, Kpélafia Mohamed, Goeh-Akué Edem, Damorou Findibé
Service de Cardiologie du CHU Campus, Lomé, Togo.
Service de Cardiologie du CHU Sylvanus Olympio, Lomé, Togo.
Pan Afr Med J. 2017 Jun 18;27:129. doi: 10.11604/pamj.2017.27.129.6855. eCollection 2017.
This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome.
We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed.
The prevalence of PE was 3.1%. Female/male sex ratio was 2.2. The average age was 52.7 ± 14.4 years. Risk factors for venous thromboembolic disease VTD were dominated by: obesity (54.9%), bedrest (25.5%) and long journey (17.6%). The main symptoms were: dyspnoea (98.0%), chest pain (78.4%) and cough (60.8%). Wells' score was high in 29.4% of cases. ECG showed: tachycardia (78.4%), right ventricular hypertrophy (RVH)(49.0%), S1Q3T3 aspect (47.1%) and right block (39.2%). Transthoracic Doppler echocardiogram showed right cavitary dilation and right intraventricular thrombus in 5.6% of cases. Thoracic angioscanner was normal in 9.8% of cases and showed embolus in 82.4% of cases. Treatment was based on Low Molecular Weight Heparin (LMWH) at therapeutic doses with antivitamin K (AVK) relay. Thrombolysis was performed in 8 patients. Evolution was favorable in 86.3% of cases. Case-fatality rate was 13.7%.
The prevalence of PE is relatively low in our area but it is probably underestimated. PE is a therapeutic problem in Togo because of the high cost of complementary examinations and thrombolysis. Prevention is therefore the only effective weapon.
本研究对洛美大学医院校区肺栓塞的进化、临床和流行病学方面进行了分析。
我们进行了一项为期39个月(2011年11月1日至2015年1月31日)的回顾性、分析性和描述性研究。对大学医院校区心脏病科因肺栓塞住院的所有患者的病历进行了分析。
肺栓塞的患病率为3.1%。女性/男性性别比为2.2。平均年龄为52.7±14.4岁。静脉血栓栓塞性疾病(VTD)的危险因素主要有:肥胖(54.9%)、卧床休息(25.5%)和长途旅行(17.6%)。主要症状为:呼吸困难(98.0%)、胸痛(78.4%)和咳嗽(60.8%)。29.4%的病例Wells评分较高。心电图显示:心动过速(78.4%)、右心室肥厚(RVH)(49.0%)、S1Q3T3波形(47.1%)和右束支传导阻滞(39.2%)。经胸多普勒超声心动图显示5.6%的病例有右心房扩张和右心室内血栓形成。9.8%的病例胸部血管扫描仪检查结果正常,82.4%的病例显示有栓子。治疗以治疗剂量的低分子肝素(LMWH)为基础,并继以维生素K拮抗剂(AVK)。8例患者进行了溶栓治疗。86.3%的病例病情好转。病死率为13.7%。
我们地区肺栓塞的患病率相对较低,但可能被低估了。由于辅助检查和溶栓治疗费用高昂,肺栓塞在多哥是一个治疗难题。因此,预防是唯一有效的武器。