OVERVIEW
OVERVIEW
Pulmonary infarction is a clinical and pathophysiologic syndrome of hemorrhage and necrosis of lung tissue due to pulmonary embolism caused by an extrapulmonary embolus. It can be life-threatening in severe cases.
Are you insured?
Yes
Department
Emergency Medicine, Respiratory Medicine
Clinical symptoms
Dyspnea, chest pain, hemoptysis, cyanosis, palpitations, shock, syncope, etc.
Hazard
If not treated in time, it can be life-threatening.
Examination
Plasma D-dimer, electrocardiogram, echocardiogram, arterial blood gas analysis, lung ventilation-perfusion scan, CT pulmonary angiography, etc.
Diagnosis
Diagnosis is based on sudden onset of dyspnea, chest pain, hemoptysis, cyanosis, palpitations, etc., combined with pulmonary ventilation-perfusion scanning, CT pulmonary angiography and other tests.
Treatment principle
Rescue life, stabilize the condition, make pulmonary blood flow recirculation, and at the same time prevent progression to chronic pulmonary embolism. In the acute stage, anticoagulation and thrombolytic therapy should be used, and interventional therapy or surgical therapy should be chosen if internal medicine treatment is difficult to be effective.
Curability
Early diagnosis and treatment can save lives; if not treated in time, it can be life-threatening.
Dietary advice
Give nutritious and easily digestible diet.
Etiology
Etiology
This disease is related to surgery, childbirth, bone fracture, malignant tumor, venous blood flow stagnation, and venous wall injury.
Symptoms and Diagnosis
Typical symptoms
Sudden onset of dyspnea, chest pain, hemoptysis, cyanosis, palpitations, shock, fainting, paroxysmal hyperventilation or
Right heart failure.
Diagnostic basis
1. Clinical manifestations
Sudden onset of dyspnea, chest pain, hemoptysis, cyanosis, palpitation, shock, syncope, paroxysmal hyperventilation.
2.Auxiliary examination
(1) X-ray film: find flaky shadow of lung parenchyma with or without pulmonary atelectasis, pleural exudation, slender shadow of pulmonary vascularization or elevation of hemidiaphragm.
(2) Pulmonary angiography: shows blockage of pulmonary vascular blood flow.
(3) Lung ventilation-perfusion scan: with radionuclide 133Xe inhalation scan and lung perfusion scan, the former is normal while the latter shows defects, mostly pulmonary embolism.
(4) Electrocardiogram: shows rightward deviation of the electrical axis, extreme clockwise rotation, or right atrial and right ventricular hypertrophy.
(5) Blood gas analysis: partial pressure of oxygen is reduced or less than 12kPa, partial pressure of carbon dioxide is less than 4.7kPa.
(6) Blood routine: increased white blood cell count, increased total bilirubin, increased lactate dehydrogenase.
Treatment
Treatment policy
Rescue life, stabilize the condition, recirculate pulmonary blood flow, and prevent progression to chronic pulmonary embolism. In the acute stage, anticoagulation and thrombolytic therapy should be used. If internal medicine is not effective, interventional therapy or surgical therapy can be chosen.
Drug treatment
1. Anticoagulation therapy, such as heparin, warfarin, etc.
2. Thrombolytic therapy, such as urokinase.
3. Dulcolax can be injected into the muscle for severe chest pain; in order to alleviate the pulmonary vascular and coronary artery spasm caused by high vagal tension, atropine can be injected into the static injection or opium poppy alkaloids.
4. For those with heart failure or arrhythmia, fast cardiotonic agents, diuretics, or antiarrhythmic drugs should be applied.
5. Antibiotics are given to those who are infected.
Surgical treatment
For those who are ineffective in general treatment and have no improvement in shock treatment, selective pulmonary arteriography can be performed, and surgical treatment can be considered under the premise of clarifying the site of embolus.
Other treatments
1. Oxygen intake.
2. Early antishock treatment for hypotension.
Prognosis
If not treated in time, it can be life-threatening; if diagnosed and treated early, the mortality rate can be reduced.
Nursing care
Daily care
1. Keep the environment quiet and tidy, with appropriate temperature and humidity.
2. Avoid contact with smoke and dust.
3. Take medication as prescribed by the doctor and review regularly.
4. Pay attention to rest and appropriate activities.
Diet
Give nutritious and easy-to-digest diet.