妇科疾病患者发生肺栓塞二例并文献复习

肺栓塞是临床上少见又凶险的疾病之一，其漏诊率、误诊率均很高。肺栓塞临床表现缺乏典型特异性，轻者可完全无症状，重者一旦发病即可猝死。栓子的大小、数量、栓塞的部位及患者是否存在心、肺等器官的基础疾病决定了肺栓塞的临床表现及病情轻重。肺栓塞患者常见的危险因素包括久坐不动（如长期卧床不起及长时间乘车）、下肢骨折、较大的手术、有静脉血栓栓塞病史、恶性肿瘤和口服避孕药等。临床医生应学会识别肺栓塞的高危因素，有高危因素的妇科疾病患者一旦发生原发病无法解释的症状或有肺栓塞的临床表现，应警惕肺栓塞的可能。早期诊断及溶栓治疗是抢救成功的关键。

Two Cases of Pulmonary Embolism in Patients with Gynecological Diseases and Review of the Literature

Pulmonary embolism is one of the rare and dangerous diseases in clinic. The rate of missed diagnosis and misdiagnosis is very high. The clinical manifestations of pulmonary embolism are lack of typical specificity, mild patients can be completely asymptomatic, while severe patients can die of sudden death once they become ill. The clinical manifestation and severity of pulmonary embolism are determined by the size and quantity of embolus, the location of embolism and the presence of heart, lung and other basic diseases. Common risk factors for pulmonary embolism include sedentary intolerance (such as prolonged bed rest and long driving), lower limb fractures, major surgery, a history of venous thromboembolism, malignancies, and oral contraceptives. The clinicians should learn to recognize the high risk factors of pulmonary embolism. Patients with gynecological diseases with high risk factors should be alert to the possibility of pulmonary embolism once they have unexplained symptoms or clinical manifestations of pulmonary embolism. Early diagnosis and thrombolytic therapy are the key to successful rescue.