老年人急性肺栓塞诊治分析

目的:探讨老年人急性肺栓塞(PTE)的临床特点及诊断方法。方法:对9例急性PTE老年患者(>70岁)的临床表现、检查、诊断及治疗方法进行回顾性分析。结果:9例急性PTE患者中,表现为不典型胸痛5例,呼吸困难3例,活动后气短1例,首诊误诊率为66.675。D-二聚体大于500mg/L者8例(占88.89%),血气分析异常者7例(占77.78%),3例核素肺扫描和6例肺血管增强CT均有PE诊断依据。9例患者血液动力学均稳定,经抗凝、降低肺动脉压力等治疗,临床症状均有明显好转。结论:老年急性PTE的临床表现不特异,容易误诊,早期诊断、早期溶栓、抗凝治疗可明显改善老年急性PTE患者预后。

Analysis on Diagnosis and Treatment of Acute Pulmonary Embolism in the Elderly

Objecrlve:To evaluate the clinical characteristics and diagnostic methods of acute pulmonary embolism in elderly.Methods: To retrospectively analyze the clinical manifestations,detection,diagnosis and treatment in 9 cases(age>70years)with acute pulmonary embolism.Results:Of 9 patients,atypical chest pain 5,dyspnea 3,shortness of breath on exertion 1,the first misdiagnosis rate was 66.67%. D-dimer is greater than 500mg/L 8(88.89%),abnormal blood gas analysis 7(77.78%),radionuclide scan and enhanced CT of lung showed evidence of pulmonary embolism in 3 cases and 6 cases respectively.9 patients were all in stable hemodynamics,the clinical symptoms were significantly improved by anticoagulant、reduction of pulmonary artery pressure therapy et al.Conclusion:The clinical manifestations of acute pulmonary embolism are not specific and can be easily misdiagnosed.Eearly diagnosis and early treatment can significantly improve the prognosis of acute pulmonary embolism in elderly.