ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN TẮC ĐỘNG MẠCH PHỔI TẠI KHOA HỒI SỨC TÍCH CỰC, BỆNH VIỆN THANH NHÀN GIAI ĐOẠN 2020–2025

Abstract

Objective: To describe the clinical and paraclinical characteristics and evaluate treatment outcomes of patients with acute pulmonary embolism (PE) admitted to the Intensive Care Unit (ICU) of Thanh Nhan Hospital. Methods: A retrospective cross-sectional study was conducted on 30 patients aged ≥18 years diagnosed with acute PE by multislice CT pulmonary angiography and treated in the ICU from January 2020 to October 2025. Clinical features, laboratory results, imaging findings, risk stratification, treatment modalities, and outcomes were extracted from medical records and analyzed using SPSS 16.0. Results: The mean age was 68.9 ± 11.6 years; 63.3% were male; 83.3% had at least one comorbidity. Dyspnea (83.3%) and chest pain (63.3%) were the predominant symptoms, and 23.3% presented with shock or hypotension. The mean P/F ratio was 220 ± 80; lactate 2.8 ± 1.2 mmol/L; D-dimer was elevated in 90%. CT imaging showed central or bilateral emboli in 46.7% and deep vein thrombosis in 36.7%. Right ventricular dilatation was observed in 60%. Treatment included anticoagulation (63.3%), thrombolysis (26.7%), and catheter-based intervention (10%). Complete reperfusion was achieved in 53.3%, while residual thrombus and clinical deterioration or recurrence occurred in 30% and 16.7%, respectively. ICU mortality was 16.7%. Bleeding occurred in 23.3%, including 10% major bleeding, predominantly in thrombolysis-treated patients. High-risk patients per ESC/ERS stratification had a mortality rate of 30%. Conclusion: Acute PE patients admitted to the ICU were generally elderly with multiple comorbidities and substantial thrombus burden. Anticoagulation remained the mainstay therapy, whereas thrombolysis and catheter-based interventions were selectively applied. ESC/ERS 2019 risk stratification demonstrated clear prognostic value and supported therapeutic decision-making.