肺栓塞右心功能的超声心动图分型、评估及治疗研究

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1、授予单位代码10089学号或申请号13607HebeiMedicalUniversity硕士学位论文在职科学学位肺栓塞右心功能的超声心动图分型、评估及治疗研究学位申请人：郑琨导师：邓晓蕴教授专业：内科学二级学院：唐山工人医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组〉的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北

2、医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。.；研究生签名：感导师签章:二级学院领导盖章：ti^年》月>曰河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。中文摘要目录中文摘要·····················································

3、························1英文摘要·············································································3英文缩写·············································································6研究论文右心功能的超声心动图分型、评估及治疗研究前言······································

4、·······································7材料与方法····································································8结果·············································································11附图························································

5、·····················12附表·············································································14讨论·············································································20结论··································································

6、···········21参考文献·······································································22综述右心功能超声心动图分型在肺栓塞治疗及预后评估的应用价值·24致谢···················································································33个人简历········································

7、·····································34中文摘要肺栓塞右心功能的超声心动图分型、评估及治疗研究摘要目的：肺动脉栓塞是来自静脉系统或右心腔内的栓子脱落或其他异物进入肺动脉,造成动脉栓塞所引起的一系列病理生理过程。是临床多发病、常见病之一。肺栓塞临床表现复杂，轻者可表现为无症状或仅有短暂呼吸困难，重者可出现急性心源性休克、室颤而猝死。在美国肺栓塞每年发病人数为30-60万，每年死亡人数10-20万，病死率达30%。在西方国家肺栓塞病死率仅次于肿瘤和冠心病，居第三位。国

8、外文献报道，未经过治疗的肺栓塞患者病死率可达90%，而经过正确积极地治疗的患者，病死率可降至10%。因此如何准确地识别高危病患，及时采取准确有效的治疗方案是临床医生必须要解决的一个极为重要的问题。目前国内外学者从不同的角度建立了多种临床评分方法，用于指导肺栓塞的危险分层和治疗。而临床上对于血压正常而右心室功能不全的次大块肺栓塞治疗意见尚不一致。由于右心室不对称、不规则的独特解剖特点,采用实时三维超声心动图技术、多普勒技术和组织多普勒技术的联合应用能够准确