探討128層螺旋CT在肺動脈栓塞中的應用價值

　　【摘要】 目的：肺動脈栓塞病癥患者應用128層螺旋CT進行病癥診斷，對其診斷結果進行討論研究。方法：參與本研究的疑似肺動脈栓塞55例患者均進行128層螺旋CT檢查，對其檢查診斷結果進行研究討論。結果：所有患者接受128層螺旋CT檢查，診斷結果陽性率為67.27%。從動脈栓塞情況來看其中以葉肺動脈栓塞、肺動脈主干栓塞、段肺動脈栓塞和左右肺動脈栓塞為主，分別為19、1、59和
　　2支，共計81支。將其進行整理歸納可以總結為累及左側肺動脈和累及右側肺動脈，其所占比例分別為62.96%和37.04%。經128層螺旋CT檢查能夠確定動脈血栓的征象可以分成直接征象和間接征象。本研究診斷陽性的37例患者動脈血栓直接表象來講，其中以附壁性、中心性、完全梗阻和偏心性為主，其四種表現的栓子數量分別為10、27、9和35處。同時再從診斷陽性的37例患者動脈血栓間接征象來看，其中主要包括肺動脈高壓、馬賽克特征、肺梗死和胸腔積液，其分別為16、25、3和22例。本研究檢驗確診的37例肺動脈栓塞病癥患者均經過臨床治療癥狀好轉。結論：在肺動脈栓塞病癥的臨床診斷中應用128螺旋CT操作簡單、安全、明顯，同時在掃描檢查過程中能夠準確確定實際患病程度、栓塞情況及栓塞的位置和數量等，能夠提高病癥診斷的準確性能夠也能夠為臨床治療方案制定予以參考作用。
　　【關鍵詞】 肺動脈栓塞； 128層螺旋CT
　　Explore the Application Value of 128 Slice Spiral CT in Pulmonary Embolism/WEN Jianxiong，LU Jieyuan，WANG Renguo，et al.//Medical Innovation of China，2018，15（07）：141-144
　　【Abstract】 Objective：To investigate the diagnosis of pulmonary embolism by using 128 slice spiral CT.Method：A total of 55 patients with suspected pulmonary embolism were underwent 128 slice spiral CT examination，and the results of diagnosis and treatment were discussed.Result：All patients were received 128 slice CT examination，the positive rate of diagnosis was 67.27%.A total of 81 pieces of embolus were found in 37 cases，which were found among 19 pulmonalis lobar arteria，1 pulmonary artery trunk，59 pulmonalis segmental arteria，2 pulmonalis dextra arteria.It can be summarized as the involvement of the left pulmonary artery（62.96%）and the right pulmonary artery（37.04%）.The appearance of arterial thrombosis were divided into direct signs and indirect signs by 128 slice spiral CT examination.The direct signs of arterial thrombosis were divided into attached artery walls（10 embolus），center（27 embolus），complete obstruction（9 embolus）and eccentric（35 embolus）. The direct signs of arterial thrombosis were divided into pulmonary artery pressure（16 cases），mosaic features（25 cases），pulmonary infarction（3 cases）and pleural effusion（22 cases）.37 cases of pulmonary embolism were improved by clinical treatment.Conclusion：The application of 128 slice spiral CT in the diagnosis of pulmonary embolism disease has the advantages of simple operation，safety and obvious.Meanwhile，it can accurately determine the actual prevalence and degree of embolism，embolism position and quantity in scanning process.Therefore，the application can improve the accuracy of diagnosis，and be able to develop for clinical reference treatment plan.
　　【Key words】 Pulmonary embolism； 128 slice spiral CT
　　First-author’s address：People’s Hospital of Gaoyao District，Zhaoqing 526040，China

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