Læknablaðið

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Læknablaðið - 01.04.1973, Page 11

Læknablaðið - 01.04.1973, Page 11
LÆKNABLAÐIÐ 43 Mikilvægi lungnareks er ekki eingöngu bundið fjölda sjúklinga, sem fá sjúkdóm- inn, heldur og því, hve stór hluti þeirra, er hann drepur, hefði ella lifað. Ef dregn- ir eru frá 27 sjúklingar (5 af 10, sem höfðu verið greindir með lungnarek fyrir dauða og 22 af 39, sem ekki voru greindir), sem hafa engar batahorfur, þ. e. a. s., sem deyja, þó að lungnarek komi ekki til, eru eftir 24 sjúklingar. Það er einkum hjá þessum sjúklingum, sem mikilvægt er að greina sjúkdóminn. Hjá okkur voru 20,4% greindir fyrir dauða. í svipaðri rannsókn á lyfjadeild í Danmörku voru aðeins 14% greindir.9 Fullkomnari rannsóknir, sem eru sér- staklega gagnlegar við greininguna, svo sem lungnascan, blóðgasmælingar og lungna-æðamyndir, voru ekki tiltækar á þessum tíma. Nú eru þessar rannsóknir gerðar á deildinni og er þess að vænta, að þær bæti greininguna til muna. SUMMARY A clinical study of pulmonary embolism over a ten year period 1961-1970, in the Medical Department, Landspítalinn, Reykjavík. There are 102 cases of pulmonary embolism, of whom 51 lived ahd 51 died. 49 cases came to autopsy. Those that lived were generally much youn- ger than those who died. Women were more numerous among the patients who lived. The clinical picture is studied, predisposing causes, symptoms and signs are enumerated. The relative importance of the various labora- tory studies as well as chest X-ray and electro- cardiogram in the diagnosis of puimonary em- bolism is evaluated. , The importance of pulmonary emboli as a cause of death is evaluated. The patients who died were of advanced age, most of them had other serious diseases, which in many cases may have been the direct cause of death or would inevitably have lead to death in the near future. , The incidence of pulmonary embolism was 0,9% among the total patient number (11.107). The incidence among those who died (644) was 7,9% (not all were autopsied). HEIMILDIR 1. Böttiger, L. E. Lungemboli. Nordisk Medi- cin 84:1462. 1970. 2. Freiman, D. G. & assoc. Frequency of pul- monary thromboembolism in man. The New Engl. J. Med. 272:1278. 1965. 3. Hilder, Frank J. & Ormond, R. S. Ac- curacy of the clinical diagnosis of Pulmon- ary embolism. JAMA 202:567. 1967. 4. Israel, H. L. & Goldstein, F. The varied clinical manifestation of pulmonary embol- ism. Annals Int. Med. 47:202. 1957. 5. Kahvan, M. & Masuoka, S. Clinical study of pulmonary embolism. Am. J. Surg. 121:432. 1971. 6. Kattadiyil, P. P. & assoc. Diagnosis of pul- monary embolism. Brit. Med. J. 3:67. 1970. 7. Morrell, M. T. & Dunnill, M. S. The post- mortem incidence of pulmonary embolism in a hospital population. Brit. J. Surg. 55:347. 1968. 8. Murril, M. S, & assoc. Diagnostic sensitivity of laboratory findings in acute pulmonary embolism. Annals Intern. Med. 74:161. 1971. 9. Pallesen, A. E. & Nörregard, S. Thrombo- embolisk lungesygdom i en medicinsk af- deling. Ugeskr. f. lœger 127:1493. 1965. 10. Phelps, M. D. Jr. Thrombophlebitis and pulmonary embolism. Med. Clin. North Am. 53:341. March 1969. 11. Towbin, A. Pulmonary embolism. JAMA 156:209. 1954.

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