Analysis on autopsy data in 47 cases of pulmonary thromboembolism / 重庆医学

ABSTRACT

Objective To investigate the autopsy clinicopathological characteristics of pulmonary thromboembolism(PTE)and to improve the understanding of PTE.Methods The clinicopathological data of 47 death cases of PTE verified by autopsy in the Chongqing Medical University during 2004? 2015 were retrospectively analyzed.Results A total of 784 cases of autopsy were completed during these 12 years,of which 47 cases(6.0％) were proved as PTE (2 cases complicating fat embolism) and 46 cases (97.9％) were fatal pulmonary embolism (FPE).The analysis on 47 cases of autopsy data found that each case had at least 1 risk factor and 43 cases (91.3％) had two or more risk factors,and the most common risk factors were traumatic fracture(55.3％) and surgery (53.2 ％).The frequent clinical symptoms were dyspnea (40.4 ％),cardiac arrest (31.9 ％) and syncope(27.7 ％);24 cases (51.1％) were complicated with deep venous thrombus (DVT) of lower limbs,8 cases (17.0％) of complicating right cardiac thrombus and 1ease (2.1％) of basilar artery embolism were found.The embolism location was dominated by main pulmonary artery (59.6 ％),including 20 cases (42.6 ％) of straddling type pulmonary embolism.Twenty-two cases (46.8 ％) were suspiciously diagnosed as PTE before death,but none was given anticoagulation or thrombolytic therapy.Only 1 case had low molecular heparin to prevent thrombosis.Conclusion PTE is more likely to occur in those patients with high risk factors,especially traumatic fractures and surgeries.Its clinical symptoms have no specificity,lack triad syndrome,has higher misdiagnosis rate,missed diagnosis rate and fatality rate.The treatment on suspected PTE patients by clinicians is insufficient.