非典型肺栓塞症临床分析

发布时间：2018-12-26 10:11

【摘要】：目的分析非典型肺栓塞症误诊的常见原因,提高对非典型肺栓塞症的认识。方法回顾性分析第三军医大学新桥医院及泸州医学院附属医院心血管内科、呼吸内科2006年1月至2013年12月临床确诊的120例非典型肺栓塞症患者的危险因素、临床表现、实验室及影像学检查资料。结果 120例非典型肺栓塞症入院时误诊39例(误诊率32.5%)。误诊为急性冠状动脉综合征8例,冠心病稳定型心绞痛7例,慢性阻塞性肺疾病(COPD)所致慢性肺源性心脏病7例,肺炎5例,胸腔积液3例,肺结核3例,支气管哮喘3例,房间隔缺损1例,急性左心衰竭1例,心源性晕厥1例。结论非典型肺栓塞症因其临床表现缺乏特异性,很容易误诊、误治,临床医师应提高诊断与鉴别诊断水平,对于高度怀疑的患者,应尽早行肺部增强CT或肺动脉CT血管造影等检查,减少对非典型肺栓塞症的误诊。
[Abstract]:Objective to analyze the common causes of misdiagnosis of atypical pulmonary embolism and to improve the understanding of atypical pulmonary embolism. Methods the risk factors and clinical manifestations of 120 patients with atypical pulmonary embolism diagnosed from January 2006 to December 2013 in Department of Cardiovascular and Respiratory Medicine, Xinqiao Hospital, third military Medical University and affiliated Hospital of Luzhou Medical College, were retrospectively analyzed. Laboratory and imaging data. Results 39 cases (32.5%) were misdiagnosed at admission of 120 cases of atypical pulmonary embolism. Eight cases were misdiagnosed as acute coronary syndrome, 7 cases were stable angina pectoris, 7 cases were chronic pulmonary heart disease caused by (COPD), 5 cases were pneumonia, 3 cases were pleural effusion, 3 cases were pulmonary tuberculosis, 3 cases were bronchial asthma. Atrial septal defect in 1 case, acute left ventricular failure in 1 case, cardiac syncope in 1 case. Conclusion atypical pulmonary embolism is easy to be misdiagnosed and mistreated because of its lack of specificity in clinical manifestations. Clinicians should improve the level of diagnosis and differential diagnosis. Pulmonary contrast enhanced CT or pulmonary artery CT angiography should be performed as early as possible to reduce misdiagnosis of atypical pulmonary embolism.
【作者单位】：四川省隆昌县人民医院内一科;第三军医大学新桥医院全军呼吸内科研究所/全军呼吸病研究重点实验室;泸州医学院附属医院呼吸内一科;四川省泸州市第二人民医院功能科;
【分类号】：R563.5

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