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目的探讨老年人急性肺栓塞的临床特征,分析漏、误诊的原因及预防措施。方法回顾性分析并比较山东省枣庄枣矿集团中心医院29例老年人肺栓塞的病史、临床表现、放射学表现和合并的疾病。结果29例肺栓塞中均有不同性质的胸闷、气促、呼吸困难。有9例误诊,早期误诊率达31%,3例为漏诊,漏诊率为10.3%,死亡13例,死亡率达44.8%,15例好转,无变化1例。结论老年人肺栓塞临床表现多样而无特征性,极易漏诊和误诊,临床医师应提高对肺栓塞的认识,降低漏、误诊率,做到早期诊断和及时治疗。
Objective To investigate the clinical features of acute pulmonary embolism in the elderly and analyze the causes of the missed and misdiagnosed cases and the preventive measures. Methods Retrospective analysis and comparison of the history, clinical manifestations, radiological findings and the combined diseases of 29 elderly people with pulmonary embolism in Zaozhuang Zaoju Group Central Hospital of Shandong Province were retrospectively analyzed. Results 29 cases of pulmonary embolism have different characteristics of chest tightness, shortness of breath, difficulty breathing. There were 9 cases misdiagnosed, the early misdiagnosis rate was 31%, 3 cases were missed diagnosis, the rate of misdiagnosis was 10.3%, 13 cases died, the mortality rate was 44.8%, 15 cases improved without change in 1 case. Conclusions The clinical manifestations of pulmonary embolism in the elderly are diverse and have no characteristic. They are easily missed and misdiagnosed. Clinicians should improve their understanding of pulmonary embolism, reduce the rate of missed and misdiagnosed, and make early diagnosis and prompt treatment.