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肺栓塞30例临床误诊分析
引用本文:聂凡刚,马瑞,苏平,杨建兴,蒋盛荣,杨文杰.肺栓塞30例临床误诊分析[J].大理师专学报,2014(10):51-54.
作者姓名:聂凡刚  马瑞  苏平  杨建兴  蒋盛荣  杨文杰
作者单位:大理学院保山非直属附属医院,云南保山678000
摘    要:目的:探讨肺栓塞的诊断方法,分析常见误诊原因,提高对肺栓塞的认识,降低误诊、误治。方法:收集了30例肺栓塞患者的临床表现、实验室资料及误诊情况,对误诊原因进行分析。结果:肺栓塞临床表现缺乏特异性,临床医生,尤其是部分外科医生对该病认识不足,故误诊率高。30例病例误诊肺炎11例,肺结核4例,胸膜炎3例,慢性阻塞性肺病2例,肺心病2例,急性冠脉综合征5例,急性左心衰2例,腰椎间盘突出症1例。结论:肺栓塞早期临床诊断有一定困难,临床医生应提高对病症的认识,对有高危因素患者新近出现气促、胸痛、咯血、呼吸困难和新发肺部浸润影,经治疗症状无缓解,应考虑肺栓塞可能,尽早完善CT肺动脉造影检查,减少误诊、误治。

关 键 词:肺栓塞  CT肺动脉造影  误诊

Analysis of Clinical Misdiagnosis on 30 cases of Pulmonary Embolism
NIE Fangang,MA Rui,SU Ping,YANG Jianxing,JIANG Shengrong,YANG Wenjie.Analysis of Clinical Misdiagnosis on 30 cases of Pulmonary Embolism[J].Journal of Dali Teachers College,2014(10):51-54.
Authors:NIE Fangang  MA Rui  SU Ping  YANG Jianxing  JIANG Shengrong  YANG Wenjie
Institution:(People's Hospital of Baoshan, Baoshan, Yunnan 678000, China)
Abstract:Objective:To explore the diagnostic method of pulmonary embolism and analyze the reason of misdiagnosis, in order to improve the awareness of pulmonary embolism and reduce misdiagnosis and mistreatment. Methods:Clinical manifestation, laboratory data and the status about misdiagnosis of pulmonary embolism were collected to analyze the reason of 30 cases of misdiagnosis in the People's Hospital of Baoshan. Results: Clinicians, especially the surgeons' insufficient understanding of the specific clinical symptoms of pulmonary embolism led to the high rate of misdiagnosis. There were 11 cases misdiagnosed as pneumonia; 4 cases of pulmonary tuberculosis; 3 cases of pleural effusion, 2 cases of chronic obstructive pulmonary disease; 2 cases of pulmonary heart disease; 5 cases of acute coronary syndrome; 2 cases of acute left heart failure; 1 cases of lumbar disc herniation. Conclusion: The early clinical diagnosis of pulmonary embolism was difficult, and clinicians should improve their understanding of this disease. Pulmonary embolism should be considered when patients showed symptom with chest pain, rough breathing, hemoptysis, dyspnea and new pulmonary infiltrates but not improved after treatment. Meanwhile, CT pulmonary artery angiography should be improved to reduce misdiagnosis and mistreatment.
Keywords:pulmonary embolism  CT pulmonary angiography  misdiagnosis
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