Which pulmonary embolism are to behave and how to diagnose? 's symptom

Which pulmonary embolism are to behave and how to diagnose? 's symptom
Which pulmonary embolism are to behave and how to diagnose?
Clinical manifestation
The clinical manifestation of pulmonary embolism can not have from symptom to unexpected death. Common symptom aches for dyspnea and chest, the incidence is more than 80%. Pleura pain is due to neighbouring pleura cellulose inflammation, the persons who took place suddenly often point out the lung and block up. The diaphragm pleura is given much trouble and can be radiated to the shoulder or belly. Pain behind if there is brestbone, are quite like myocardial infarction. The chronic lung can spit blood to block up. Other symptoms are anxious, it may be due to pain or hypoxemia disease. It is often the sign that the lung blocks up to faint.
Common physical sign increases, the wet rale of cyanosis, lung or sound of chirping of heavy breathing fast in order to breathe, lung blood vessel noise, the pleura fricative or thorax accumulates the liquid to solicit. Circulatory system physical sign have tachycardia, and shock or anxious chronic lung worry display while being corresponding. About 40% of the patients have low to medium-sized degree to generate heat, a few patients have hyperpyrexia in early days.
Diagnosis
Clinical symptom and physical sign non- specific often, and change quite big, with other cardiovascular vessel being difficult to distinguish in disease. Though the weight of symptom relates to embolus size, thromboembolism range, might not be directly proportional to, often have close relations with original heart, compensation ability of the lung disease.
(1) Pulmonary embolism of acute large area: The ones that are shown as and broken out suddenly are severe to have difficulty in breathing, myocardium the intersection of infarction and pain under kinds of brestbone, faint, cyanosis, right heart depleted fainting coldly and twitching by shock, profuse sweating, four limbs. The heart stops fighting or the room dies quiverly and rapidly to even happen.
(2) Pulmonary embolism of the medium-sized size: Pain behind often having brestbone and spitting blood. When it is very bad that patient's original heart, lung disease compensate the function, can produce fainting and hypertension.
(3) The little thromboembolism of the lung: Can produce adults and breathe poverty-stricken syndrome.
(4) Infarction of lung: Often have generating heat, slight jaundice.
About 20%- 30% of the patients have not or failed to be diagnosed and treated and died in time, if can diagnose and for the anticoagulatory treatment in time, the case fatality rate can be expected to drop to 8%, so early diagnosis is very important. Should collect the medical history carefully. Serum LDH is raised, the arterial blood PO2 drops, PA-aO2 increases widely. The electrocardiogram has T waves and section ST that change (the similar myocardial infarction figure) , P wave and QRS wave form change (the similar acute lung worry figure) . The X-ray does not reveal spot slice soaking, lung one, diaphragm skin raising, thorax accumulate the liquid, especially regard pleura as the basal convex to move towards the round dense shade (Hamptom hump) in the lung door And the lung artery expanded accompanies and carries the lung line far sparsely (Westermark solicit) ,etc. to diagnosis of pulmonary embolism capital values important. Nuclide lung keep in touch with pour into, scan, diagnose the intersection of pulmonary embolism and there is not creating methodding most sensitive, although the specificity is low, there are typical occuring frequently, segment or Tenneco to pour into defect and keep in touch with normally or increase, it is clinical to combine, diagnose that can establish. Diagnose the most peculiar method of pulmonary embolism in artery radiography of lung, are suitable for the clinic and nuclide to scan suspiciously and needing the case of surgery treatment. It show as blood vessel it last defect, block at artery or " The evidence of prunning branches " . Radiography can't reveal, less than or equal to the intersection of 2mm and the intersection of diameter and small blood vessel, so person who occur frequently light thromboembolism often easy to leak, examine. Magnetic resonance, for having technologying of creating etc. useful that pulmonary embolism diagnose, can see the obvious lung artery and fill defect when the relatively loud thromboembolism.
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