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目的 进一步提高对致死性肺血栓栓塞症临床特点的认识。方法 回顾分析 1982年 11月～ 2 0 0 1年 2月经尸检证实的致死性肺血栓栓塞症 36例。结果 生前诊断仅 6例 ,合并有COPD、心血管疾病或恶性肿瘤的肺栓塞生前诊断率更低。有 4例患者无风险因素存在。临床多表现为呼吸困难突然发作或加重、晕厥、猝死 ,而胸痛及咯血少见 ,2 5 %的患者出现循环衰竭。对 4例采取了预防血栓栓塞的措施。结论 常见的与肺血栓栓塞相关的临床表现并不能作为致死性肺血栓栓塞的诊断依据 ,其原因主要是病人缺乏典型的症状及体征 ,并且存在交流困难(例如昏迷或麻醉 )、猝死以及与其他疾病共存等问题
Objective To further improve the understanding of the clinical features of fatal pulmonary thromboembolism. Methods Thirty-six cases of fatal pulmonary thromboembolism confirmed by autopsy from November 1982 to February 2001 were retrospectively analyzed. Results In prenatal diagnosis, only 6 cases were diagnosed with pulmonary embolism with COPD, cardiovascular disease or malignancy before diagnosis. Four patients had no risk factors. Clinical manifestations of sudden onset or aggravating dyspnea, syncope, sudden death, and chest pain and hemoptysis rare, 25% of patients with circulatory failure. In 4 cases taken to prevent thromboembolism measures. Conclusions The common clinical manifestations associated with pulmonary thromboembolism are not the basis for the diagnosis of fatal pulmonary thromboembolism due to the lack of typical symptoms and signs of the patient and the difficulty of communicating with others such as coma or anesthesia, sudden death, and other Coexistence of diseases and other issues