摘要目的 提高对骑跨型肺栓塞的认识,为探讨其发病过程及制定合理的治疗方案提供依据.方法 对我院2004年1月至2012年1月经CT肺动脉造影(CTPA)检查确诊的骑跨型肺栓塞患者进行回顾性分析 结果 经CTPA确诊肺栓塞338例,其中骑跨型肺栓塞15例,占4.4％男7例,女8例,平均年龄(57±13)岁 肺动脉分叉处完全阻塞1例,部分阻塞14例 伴休克l例,伴低血压3例,血流动力学稳定11例,伴卯圆孔骑跨栓l例.溶栓治疗5例,单纯抗凝治疗9例,行血栓清除术1例.治愈5例,好转10例,末见死亡病例.治疗过程中轻微出血2例,无大出血病例结论 本组骑跨型肺栓塞发病率与国外报道基本一致,但这一发病率可能被低估,对于血流动力学稳定, 且不伴有卵圆孔骑跨栓的骑跨型肺栓塞患者并不需要积极地溶栓或手术治疗.

abstractsObjective To improve recognition of saddle pulmonary embolism (SPE).Methods A retrospectively review was performed for patients diagnosed with SPE determined by CTPA from Jan 2004 to Jan 2012.Results Fifteen SPE patients(4.44％) were found in 338 documented PE patients confirmed by CTPA.There were 7 males and 8 females,with an average age of (57 ± 13) years.The bifurcation of the main pulmonary artery was completely blocked in one case,while partial obstruction was found in the others.Hemodynamic stability was observed in 11 cases,shock in 1 case,and hypotension in 3 cases.Thromboembolectomy was performed in 1 case accompanied by patent foramen ovale straddling thrombus,and thrombolytic therapy was administered in 5 cases while anticoagulant therapy alone in 9 cases.All the cases survived.Minor bleeding was observed in 2 patients and no major bleeding occurred.Conclusion The prevalence of SPE in this series was similar to that reported in the literature.But the incidence might beunderestimated.Mortality rate was low.No more aggressive therapeutic interventions (thrombolytics or catheter thrombectomy) were needed in those patients with hemodynamic stalbility and without patent foramen ovale straddling thrombus.