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肺栓塞(PE)临床表现复杂多样,误诊率较高,其针对性治疗不及时或缺如,导致目前PE的病死率达30%,因此早期诊断和及时治疗非常重要。本文回顾分析近年来20例误诊为其他疾病的PE患者临床资料,探讨分析其误诊原因。1对象与方法肺栓塞诊断标准:符合下面(1)-(3)任意一项者可确诊。(1)选择性肺动脉造影(CPA)显示肺动脉阻塞充盈缺损。(2)肺螺旋CT显示段以上肺动脉低密度充盈缺损。(3)肺通气灌注扫描(ECT)显示病灶部位血流灌注缺失、而通气正常或接近正常者。本组基础疾病:骨折3例,风心病2例,肺源性心脏病6例,术后4例,冠心病1例,无基础疾病者4例。临床表现(均为例次)气短、呼吸困难18例,胸痛15例,咯血3例,急性腹痛1例,血压下降4例,双肺满布哮鸣音1例,湿
The clinical manifestations of pulmonary embolism (PE) are complex and diverse, and the misdiagnosis rate is high. The targeted treatment is not timely or absent, resulting in the current PE mortality rate of 30%, so early diagnosis and timely treatment is very important. In this paper, we retrospectively analyzed the clinical data of 20 PE patients misdiagnosed as other diseases in recent years and analyzed the causes of misdiagnosis. 1 Subjects and Methods Pulmonary Embolism diagnostic criteria: meet any of the following (1) - (3) can be diagnosed. (1) Selective pulmonary angiography (CPA) showed pulmonary artery occlusion filling defects. (2) Spiral CT showed segments of low pulmonary artery filling filling defect. (3) Pulmonary ventilation perfusion scan (ECT) showed the absence of perfusion in the lesion, while normal ventilation or near normal ventilation. The group of basic diseases: fracture in 3 cases, 2 cases of rheumatic heart disease, pulmonary heart disease in 6 cases, 4 cases after surgery, coronary heart disease in 1 case, no underlying disease in 4 cases. Clinical manifestations (all cases) Shortness of breath, dyspnea in 18 cases, 15 cases of chest pain, hemoptysis in 3 cases, 1 case of acute abdominal pain, 4 cases of decreased blood pressure, lung full of wheeze in 1 case, wet