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[慢性全心衰患者的肺栓塞和下肢血栓形成]

[Thromboembolism of the lung and lower extremities in patients with chronic global congestive heart failure].

作者信息

Carrasco Guerra H, Avilán L M, Barboza J S, Fuenmayor A, Dávila D, Pérez T

出版信息

Arch Inst Cardiol Mex. 1978 Jan-Feb;48(1):214-32.

PMID:666434
Abstract

The results of a prospective study on the incidence of pulmonary thromboembolism and deep leg veins phlebitis in patients with congestive heart failure are presented. Pulmonary thromboembolism was diagnosed by means of pulmonary isotopic scanning and angiography; deep leg veins were studied using conventional and isotopic phlebography. A total incident of 60% for pulmonary thromboembolism and 92% for deep leg veins phlebitis was found, being of little significance the results suggested by clinical signs. ECG, chest X rays and laboratory tests such as arterial PO2, transaminase and lactic dehidrogenases. Among patients with pulmonary thromboembolism, the hospitalization periods were longer and more frequent, the incidence of deep leg veins phlebitis was 100%, mortality was slightly higher and the degree of hemodynamic derrangement was more advanced in patients without pulmonary thromboembolism. The rutinary use of pulmonary scanning and isotopic phlebography for detection of these complications in patients with congestive heart failure is recommended, emphasizing the need for prophylactic anticoagulant treatment in most of these patients.

摘要

本文呈现了一项关于充血性心力衰竭患者肺血栓栓塞症和下肢深静脉炎发病率的前瞻性研究结果。肺血栓栓塞症通过肺同位素扫描和血管造影进行诊断;下肢深静脉采用传统静脉造影和同位素静脉造影进行研究。结果发现,肺血栓栓塞症的总发病率为60%,下肢深静脉炎为92%,临床体征提示的结果意义不大。心电图、胸部X光以及动脉血氧分压、转氨酶和乳酸脱氢酶等实验室检查。在发生肺血栓栓塞症的患者中,住院时间更长且更频繁,下肢深静脉炎的发病率为100%,死亡率略高,且无肺血栓栓塞症患者的血流动力学紊乱程度更严重。建议对充血性心力衰竭患者常规使用肺部扫描和同位素静脉造影来检测这些并发症,并强调大多数此类患者需要预防性抗凝治疗。

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