早期肺动脉造影阴性青年急性肺栓塞一例并文献复习

目的拓展对青年急性肺栓塞（APE）的认识,减少误诊、漏诊率。方法对下肢静脉及肺血管造影均阴性的青年肺栓塞误诊为右下肺肺炎临床资料进行回顾性分析。结果患者临床表现为呼吸困难,胸痛及痰中带血;D-二聚体阳性,动脉血气分析提示氧分压（PaO2）进行性下降,肺泡动脉氧分压差（PA-a02）进行性增大,病初肺动脉造影阴性,后复查肺动脉造影（CTPA）阳性明确诊断,治愈出院。2月后门诊随诊,复查CTPA血栓消失。结论肺栓塞误诊率、漏诊率高,临床医生应高度重视该病,提高对该病的警惕性,尽早诊断及治疗,减少患者死亡率。

Early pulmonary artery angiography negative youth acute pulmonary embolism in 1 and meta-analysis and literature review

Objective To extend the understanding of the adolescent acute pulmonary embolism （ APE ） , reduce misdiagnosis and missed diagnosis rates. Methods the venous and pulmonary angiography were negative for youth pulmon- ary embolism misdiagnosed as right lower pulmonary pneumonia clinical data were retrospectively analyzed. Results The clinical manifestations of patients with dyspnea, chest pain and bloody sputum; D-dlmer positive, arterial b!ood gas analysis showed that oxygen partial pressure （PaO：） was progressive declined, alveolar-arterial oxygen difference （PA-a0：） was increased at the beginning of the disease, pulmonary angiography was negative, Then recheck of pulmonary artery angi- ography was positive definite diagnosis. And the patient was cured and leaved hospital. 2 months later, the follow-up patient with CTPA signs was negative. Conclusion The pulmonary embolism is with high misdiagnosis and missed diagnosis rates, and clinicians should attach great importance to the disease to improve the vigilance of the disease for early diagnosis and treatment as to reduce the mortality rates.