Belcaro G, Nicolaides A N, Geroulakos G, Artese L, Laurora G, Cesarone M R, de Sanctis M T, Incandela L, Ricci A, Ramaswami G, Willows L
Cardiovascular Institute, Chieti University.
Vasa. 1997 Nov;26(4):287-90.
The circadian distribution of fatal pulmonary thromboembolism in general surgical patients is unknown.
One hundred consecutive cases of pulmonary embolism, with reliable clinical notes and data, were studied (67 men and 33 women; mean age 71 years). Only post-surgical cases were considered in this analysis. Patients had undergone elective (78%) or emergency abdominal surgery (22%). Correct prophylaxis (according to the Windsor Consensus Statement) had been used in 12%. Cases were grouped according to the time of onset of signs and symptoms related to pulmonary embolism at one hour intervals.
The maximum incidence of fatal pulmonary embolism was between 7.00 a. m. and 1.00 p. m. with the highest peaks at 9.00 and 11.00 a. m. 9% of deaths) (P < 0.02). When results from this study were compared to a previous study no significant difference was observed between the distribution profile of cases from general medical wards and surgical wards.
It appears that in surgical patients there is a circadian pattern in pulmonary embolism as already documented in medical patients.
普通外科患者中致命性肺栓塞的昼夜分布情况尚不清楚。
对连续100例肺栓塞患者进行研究，这些患者有可靠的临床记录和数据（67例男性，33例女性；平均年龄71岁）。本分析仅考虑术后病例。患者接受了择期手术（78%）或急诊腹部手术（22%）。12%的患者采用了正确的预防措施（根据温莎共识声明）。根据与肺栓塞相关的体征和症状出现时间，以1小时为间隔对病例进行分组。
致命性肺栓塞的最高发病率出现在上午7点至下午1点之间，上午9点和11点出现最高峰（9%的死亡病例）（P<0.02）。将本研究结果与先前的研究进行比较时，在内科病房和外科病房的病例分布情况之间未观察到显著差异。
看来在外科患者中，肺栓塞存在昼夜模式，这已在内科患者中得到证实。
