三级护理中心收治的急性肺栓塞患者的临床概况和短期预后

Vinayak Pai, Suyash Ambekar, M. Nadkar, Alhad Mulkalwar, Priyadarshi Prajjwal
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摘要

背景:静脉血栓栓塞是全球疾病负担的一个主要因素,每年发病率约为1000万例,发病率和死亡率显著相关。目的:本研究旨在评估三级护理中心收治的急性肺栓塞(PE)患者的临床、实验室和放射学特征、心电图和超声心动图变化以及治疗和预后。并对其病因及危险因素进行了评价。材料和方法:这是一项以医院为基础的前瞻性观察性研究,对31名患者进行了为期18个月的研究。这项研究是在普通医学系的一个三级保健中心进行的。年龄超过12岁,经ct肺血管造影(CTPA)确诊为急性PE的患者被纳入研究。结果:溶栓率为12.9%,抗凝药率为87.1%。第1天需氧量为74.2%,第30天需氧量为9.7%。继发性肺动脉高压是研究中最常见的并发症,占54.8%。35.4%为重度缺氧。6.4%病例无并发症发生。死亡率为9.6%。结论:由于PE是导致死亡和残疾的主要原因之一,因此在所有临床环境中都应该高度怀疑。由于长期固定是PE患者的一个强大的危险因素,他们应该提供预防性抗凝治疗。
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Clinical profile and short-term outcomes of patients admitted with acute pulmonary embolism in a tertiary care centre
Background: Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality. Objectives: The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated. Materials and Methods: This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study. Results: Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases. Conclusion: Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.
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