肺栓塞26例误诊分析

目的提高对肺栓塞的认识和诊治水平。方法回顾性分析收治的26例肺栓塞患者的临床特点和误诊情况的临床资料。结果26例肺栓塞患者被误诊为9种疾病:分别为冠心病10例次(38%),心肌病5例次(19%),心肌炎3例次(12%),风湿性心脏病2例次(8%),感染性心内膜炎2例次(8%);慢性阻塞性肺病4例次(15%),原发性肺动脉高压3例次(12%),肺炎3例次(12%),胸膜炎、胸腔积液3例次(12%)。结论肺栓塞临床表现多样,胸片、心电图等常规检查不具特异性。肺栓塞误诊率高,其主要原因是对肺栓塞认识及辅助检查认识不全面,临床医师应提高对肺栓塞的警惕性,综合分析,早期诊断,及时治疗挽救患者生命。

Misdiagnosis of 26 cases of pulmonary embolism

Objective To improve the diagnosis and treatment of pulmonary embolism(PE). Methods Clinical data of 26 cases of PE were analyzed. Results Twenty-six cases of PE were misdiagnosed as nine kinds of disease. They were coronary heart disease in 10 case-times(38%),cardiomyopathy in 5 (19%),myocarditis in 3 (12%),rheumatic heart disease in 2 (8%),infective endocarditis in 2 (8%),chronic obstructive pulmonary disease in 4 (15%),primary pulmonary hypertension in 3 (12%),pneumonia in 3 (12%),and pleural effusion in 3 (12%). Conclusion The cases showed different clinical manifestations.Chest X-ray and ECG are nonspecific.The rate of misdiagnosis of first visit is high.The incidence and treatment of PE should be more emphasized.