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50歲張姓工程師因長時間坐在電腦前工作,近來起身活動後總會覺得呼吸喘,到胸腔科檢查並無異常,然而喘不過氣越來越嚴重,改掛心臟內科門診,檢查後發現肺動脈竟有血栓塞住,所幸透過抗凝血藥物治療後,不再氣喘吁吁。
亞洲大學附屬醫院心臟內科主治醫師許楹奇表示,患者近兩週來特別容易覺得喘,詢問日常作息,發現他因工作關係,經常一坐就是 3、 4個小時才起身,透過心電圖和胸部電腦斷層檢查後,發現患者肺動脈一個很大的血栓塞住,若不立即處理,恐怕有猝死的危險。
經收治住院,採用抗凝血藥物溶解血栓治療 1個星期後,症狀逐漸改善,並出院,目前持續使用抗凝血藥物追蹤,醫師也特別告誡他避免久坐不動,最好每半小時就起身走一走,「要活就要多動」。
許楹奇指出,肺動脈栓塞是指肺動脈血管被來自下肢深部靜脈的栓子塞住,形成栓子的物質包括固體、液體或空氣,一旦出現拴塞,會影響病患的呼吸交換,常見症狀為活動性呼吸急促、呼吸困難、胸痛、水腫,因此長期操作電腦者、乘坐長途飛機、火車者、長期臥床病患、手術後的病人等,都容易因下肢血液循環不良,引發肺動脈栓塞症狀。
許楹奇指出,因肺動脈栓塞的症狀與許多疾病類似,使得漏診比例高,故為確保呼吸急促是否與其他臟器受損相關,需進行多項檢查相互應證,才能找出元凶。
許楹奇提醒,肺栓塞患者需長期進行抗凝血藥物治療,所以應避免跌倒、拔牙等容易出血,如需拔牙,也應告知醫師目前有服用藥物;此外,肺動脈栓塞若不及早治療,恐有生命危險,且多數症狀會先以喘來表現,因此當不舒服時,應適時就醫。

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The 50-year-old engineer named Zhang was sitting in front of the computer for a long time. He always felt breathing after getting up and going to the chest. There was no abnormality in the chest examination. However, he was getting worse and worse. He was re-attached to the cardiology clinic. There is a thrombus in the pulmonary artery. Fortunately, after treatment with anticoagulant drugs, it is no longer panting.
Xu Xiaoqi, attending physician of Department of Cardiology, Affiliated Hospital of Asia University, said that the patient has been particularly prone to asthma in the past two weeks. He asked about his daily routine and found that he was usually sitting for 3 or 4 hours because of his work relationship. He passed the ECG and chest computer. After the tomography, a large thrombus was found in the patient's pulmonary artery. If not treated immediately, there is a risk of sudden death.
After being admitted to the hospital for treatment, the anticoagulant drug was used to dissolve the thrombus for 1 week. The symptoms gradually improved and were discharged. Currently, anticoagulant drugs are continuously used for tracking. The doctor also warned him to avoid sedentary. It is best to get up every half hour. Take a walk, "If you want to live, you need to move more."
Xu Yuqi pointed out that pulmonary embolism means that the pulmonary artery is blocked by an embolus from the deep vein of the lower extremity. The substance forming the embolus includes solid, liquid or air. Once occlusion occurs, it will affect the patient's respiratory exchange. The common symptoms are Active shortness of breath, difficulty breathing, chest pain, edema, so long-term computer operators, long-haul aircraft, trainers, long-term bedridden patients, patients after surgery, etc., are prone to poor blood circulation in the lower limbs, causing pulmonary embolism symptoms.
Xu Yuqi pointed out that because the symptoms of pulmonary embolism are similar to many diseases, the proportion of missed diagnosis is high. Therefore, in order to ensure whether the shortness of breath is related to the damage of other organs, it is necessary to carry out a number of tests to verify each other in order to find out the culprit.
Xu Yuqi reminded that patients with pulmonary embolism need long-term anticoagulant therapy, so they should avoid falling and tooth extraction and other bleeding. If you need to remove your teeth, you should also tell your doctor that you are taking the drug. In addition, if the pulmonary embolism is not treated early, fear It is life-threatening, and most of the symptoms will first manifest as asthma, so when you are not feeling well, you should seek medical advice at the right time.



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