心肺疾病老年人并发肺栓塞的误诊分析(附23例临床分析)

目的:提高对患心、肺系统疾病老年人并发肺栓塞的认识,探讨及时确诊措施。方法:总结23例老年人肺栓塞的临床表现、实验室检查、影像检查等诊断资料。结果:78%患者表现突发性呼吸困难,以晕厥为首发症状者5例(21.7%),100%有低氧血症,10例行下肢静脉造影者中8例有下肢静脉血栓,14例核素肺扫描和18例肺动脉造影者均有PE诊断依据。误诊时间:<2周12例,6周至2年11例。最多是误诊为心绞痛或心肌梗塞者,共19例(82.6%)结论:晕厥、突发性呼吸困难、下肢静脉血栓为疑诊肺栓塞的主要征象,核素肺扫描、肺动脉造影为其诊断主要手段。

Analysis of misdiagnosis of pulmonary embolism in aged patients with pulmonary and cardiovascular diseases (retrospective study of 23 cases with pulmonary embolism)

Objective:Analysis of misdiagnosis of pulmonary embolism(PE) in aged patients with pulmonary and cardiovascular diseases.Methods:The data of 23 cases of pulmonary embolism were retrospective study according diagnosis.Results:There was respiratory dyspnea burst in 78% patients.There were 5 patients(21.7%) with syncope appeared first.All patients(100%) had hypoxxemia.The 8 patients had embolism of low extremity vein in 10 patients performed phlebography of low extremity.All patients(100%) had diagnosis sign of PE in 14 patients performed nuclide lung scan and 18 patients preformed pulmonary arteriography.Time of misdiagnosis was <2 weeks in 12 cases,and 6 weeks to 2 years in 11 cases.The PE patients misdiagnosed to angina or myocardial infarction were most(19 cases,82.6%).Conclusion:Syncope,respiratory dyspnea burst and embolism of low extremity vein are chief sign of suspect pulmonary embolism,its main diagnosis methods are nuclide lung scan and pulmonary arteriography.