15例老年人肺动脉栓塞临床病理分析

目的分析尸检中６５岁以上老年人肺动脉栓塞（以下简称肺栓塞）的临床、病理资料，探讨老年人肺栓塞的特点及误诊原因。方法收集我院１９５１～１９９２年尸检１１１１例中老年人肺栓塞１５例，对照分析其临床、病理特点。结果男性１４例，女性１例，年龄６５～８２岁。误诊率８６．７％。原有基础病以冠心病、慢性阻塞性肺疾病（ＣＯＰＤ）、糖尿病为多。结论老年人肺栓塞病情重且复杂、临床表现不典型、各种疾病表现相互掩盖可能是误诊的主要原因

A retrospective clinicopathological study of pulmonary embolism in the elderly

Objective Pulmonary embolism is a disease rather difficult to be diagnosed correctly andwith high mortality,but it can be effectively treated.Clinicopathological study of this disease will facilitate its diagnosis.Method The clinical and pathological data ofautopsy-proven pulmonary embolism in Beijing Hospital from 1951 to 1992 were reviewed.Results Fifteen patients consisted of 14 male and 1 female.Their age ranged from 65 to 82 years.Misdiagnosis rate was 86.7%.Concomitant diseases were severe and complex,mostly coronary disease,COPD and diabetes mellitus.The clinical presentations of pulmonary embolism in the elderly are deceptively nonspecific and variable.Chest pain and hemoptysis may be absent.Conclusions The reasons for misdiagnosis of pulmonary embolism in the elderly might be the variability of clinical presentation,the presence of other concomitant disease.Frequent pursuit of aggressive or invasive diagnostic methods in suspected cases is warranted.