Menzoian J O, Williams L F
Am J Surg. 1979 Apr;137(4):543-8. doi: 10.1016/0002-9610(79)90128-4.
The records of 158 patients who underwent pulmonary angiography for the presumed diagnosis of acute pulmonary embolism were retrospectively reviewed. Of the 111 patients in the category of high probability for pulmonary embolism based on clinical impression, 60 patients (54 per cent) had a positive pulmonary angiogram. Of the forty-seven patients in the low probability group, ten (21 per cent) had a positive angiogram. Forty-eight of the seventy-three patients (66 per cent) with a high probability lung scan had a positive pulmonary angiogram. Eleven of twelve patients (92 per cent) with a high probability ventilation-perfusion scan had a positive pulmonary angiogram, and two of eight patients (25 per cent) with a low probability ventilation-perfusion scan had a positive pulmonary angiogram. The mean PO2 of patients with a positive pulmonary angiogram was 64 mm Hg, and the mean PCO2 30 mm Hg. The mean PO2 of patients with a negative pulmonary angiogram was 63 mm Hg and the mean PCO2 34 mm Hg. Based on these data, we believe that the accuracy of pulmonary angiography in diagnosing acute pulmonary embolism is much higher than that of the clinical impression, arterial blood gas determinations, and lung scanning technics.
对158例因疑似急性肺栓塞而接受肺血管造影的患者记录进行了回顾性分析。在基于临床判断被归类为肺栓塞高可能性的111例患者中，60例（54%）肺血管造影呈阳性。在低可能性组的47例患者中，10例（21%）血管造影呈阳性。73例肺扫描高可能性患者中有48例（66%）肺血管造影呈阳性。12例通气-灌注扫描高可能性患者中有11例（92%）肺血管造影呈阳性，8例通气-灌注扫描低可能性患者中有2例（25%）肺血管造影呈阳性。肺血管造影阳性患者的平均动脉血氧分压（PO2）为64 mmHg，平均动脉血二氧化碳分压（PCO2）为30 mmHg。肺血管造影阴性患者的平均PO2为63 mmHg，平均PCO2为34 mmHg。基于这些数据，我们认为肺血管造影诊断急性肺栓塞的准确性远高于临床判断、动脉血气测定和肺部扫描技术。
