床旁胸片检查结合血浆D-二聚体测定对肺栓塞的诊断价值.pdfVIP

2014 年第 27 卷第 2 期 ·诊 断 剖 析 床旁胸片检查结合血浆 D- 二聚体测定 对肺栓塞的诊断价值 郭 强，胥建民，杨辉珍 天水 407 医院，甘肃 天水 741000 ［摘 要］ 目的：探讨床旁胸片检查结合血浆 D- 二聚体 (D-dimer,DD)测定肺动脉栓塞 (pulmonary embolism,PE)的应用价值。 方法：对 16 例临床可疑 PE 患者进行床旁胸片检查结合血浆 DD 测定，以临床诊断 为依据， 分别评价床旁胸片、DD 测定以及床旁胸片检查结合血浆 DD 测定对 PE 诊断价值。 结果： 床旁胸片 Westermark 征 6 例 (37.5%)，肺动脉高压 6 例 (37.5%)(其中 2 种表现交叉者 3 例)，肺炎样改变 2 例 (12.5%)， 胸腔积液 2 例 (12.5%)，3 例 (18.75%)未见明显异常 X 线征象；DD 测定全部阳性 (16例)，阳性率 100%。 结论：床 旁胸片检查结合血浆 D- 二聚体测定是对 PE 较为准确而又迅速的诊断方法，并对疗效判定有重要价值。 ［关键词］胸部；X 线摄影；血浆 D- 二聚体；肺栓塞；血栓 ［中图分类号］R563.5 ［文献标识码］B ［文章编号］1004-6852(2014)02-0133-02 The Value of Bedside Chest X-ray and Plasma D-dimer Determination in the Diagnosis of Pulmonary Embolism GUO Qiang, XU Jianmin, YANG Huizhen Tianshui Municipal the 407th Hospital, Tianshui 741000, China Objective: To explore diagnostic value of bedside chest X-ray and plasma D-dimer (DD) determi- nation in the diagnosis of pulmonary embolism (PE). Methods: All 16 patients received bedside chest X-ray and plasma DD determination, taking clinical diagnosis as the evidence, the values of bedside chest X-ray, DD determi- nation, the combination of both in the diagnosis of PE were respectively assessed as well as clinical effects in the treatment for thrombosis. Results: There were six cases of Westermark signs showed in bedside chest X-ray (37.5%), six cases of pulmonary artery hypertension (PAH) (37.5%) (There were three cases manifesting both of the signs), two cases with pneumonia-like changes (12.5%), two cases of pleural effusion (12.5%)