D-二聚体联合肺泡血动脉氧分压差检测在诊断全麻术后急性肺栓塞的临床价值

摘要

Objective To investigate the clinical value of pulmonary alveolar-arterial oxygen pressure and D-dimer combined detection for pulmonary embolism patients after anaesthesia. Methods The study selected 41 cases with pulmonary embolism and 40 cases excluded pulmonary embolism by pulmonary angiography, then the levels of PA-aO2 and D-dimer were compared between the two groups. Results The levels of PA-aO2 and D-dimer were high-er in the pulmonary embolism group than in the non-pulmonary embolism group (P<0. 05). The incidence of pulmo-nary embolism increased significantly when PA-aO2 was higher than 50mmHg and D-dimer was higher than 500ug/L (P<0. 05). The area under of the ROC curve was 0. 8158. Conclusion PA-aO2 combined with D-dimer can better improve the diagnosis of pulmonary embolism diagnosis, especially when PA-aO2 was higher than 50mmHg and D-di-mer higher than 500ug/L, they should improve the clinical importance of early diagnosis of pulmonary embolism.%目的 探讨D-二聚体联合肺泡血动脉氧分压差检测在诊断全麻术后急性肺栓塞的临床价值.方法 选择肺栓塞患者41例,并与通过肺动脉造影排除肺栓塞者40例,比较肺栓塞组与非肺栓塞组患者PA-aO2和D-二聚体水平,并分析不同PA-aO2水平和不同D-二聚体水平发生肺栓塞情况.结果 肺栓塞组PA-aO2显著高于非肺栓塞组(P<0.05),同时D-二聚体水平显著高于非肺栓塞组(P<0.05),PA-aO2>50mmHg者发生肺栓塞的比率显著高于PA-aO2<50mmHg者(P<0.05),D-二聚体>500 ug/L者发生肺栓塞的比率显著高于D-二聚体<500 ug/L者(P<0.05),ROC曲线下面积达到0.8158.结论 PA-aO2联合D-二聚体诊断肺栓塞能更好的提高诊断率,尤其是对于PA-aO2高于50mmHg,同时D-二聚体超过500ug/L者,要提高临床重视,早期诊断肺栓塞.