【摘要】：目的分析非典型肺栓塞癥誤診的常見(jiàn)原因,提高對(duì)非典型肺栓塞癥的認(rèn)識(shí)。方法回顧性分析第三軍醫(yī)大學(xué)新橋醫(yī)院及瀘州醫(yī)學(xué)院附屬醫(yī)院心血管內(nèi)科、呼吸內(nèi)科2006年1月至2013年12月臨床確診的120例非典型肺栓塞癥患者的危險(xiǎn)因素、臨床表現(xiàn)、實(shí)驗(yàn)室及影像學(xué)檢查資料。結(jié)果 120例非典型肺栓塞癥入院時(shí)誤診39例(誤診率32.5%)。誤診為急性冠狀動(dòng)脈綜合征8例,冠心病穩(wěn)定型心絞痛7例,慢性阻塞性肺疾病(COPD)所致慢性肺源性心臟病7例,肺炎5例,胸腔積液3例,肺結(jié)核3例,支氣管哮喘3例,房間隔缺損1例,急性左心衰竭1例,心源性暈厥1例。結(jié)論非典型肺栓塞癥因其臨床表現(xiàn)缺乏特異性,很容易誤診、誤治,臨床醫(yī)師應(yīng)提高診斷與鑒別診斷水平,對(duì)于高度懷疑的患者,應(yīng)盡早行肺部增強(qiáng)CT或肺動(dòng)脈CT血管造影等檢查,減少對(duì)非典型肺栓塞癥的誤診。
[Abstract]:Objective to analyze the common causes of misdiagnosis of atypical pulmonary embolism and to improve the understanding of atypical pulmonary embolism. Methods the risk factors and clinical manifestations of 120 patients with atypical pulmonary embolism diagnosed from January 2006 to December 2013 in Department of Cardiovascular and Respiratory Medicine, Xinqiao Hospital, third military Medical University and affiliated Hospital of Luzhou Medical College, were retrospectively analyzed. Laboratory and imaging data. Results 39 cases (32.5%) were misdiagnosed at admission of 120 cases of atypical pulmonary embolism. Eight cases were misdiagnosed as acute coronary syndrome, 7 cases were stable angina pectoris, 7 cases were chronic pulmonary heart disease caused by (COPD), 5 cases were pneumonia, 3 cases were pleural effusion, 3 cases were pulmonary tuberculosis, 3 cases were bronchial asthma. Atrial septal defect in 1 case, acute left ventricular failure in 1 case, cardiac syncope in 1 case. Conclusion atypical pulmonary embolism is easy to be misdiagnosed and mistreated because of its lack of specificity in clinical manifestations. Clinicians should improve the level of diagnosis and differential diagnosis. Pulmonary contrast enhanced CT or pulmonary artery CT angiography should be performed as early as possible to reduce misdiagnosis of atypical pulmonary embolism.
【作者單位】： 四川省隆昌縣人民醫(yī)院內(nèi)一科;第三軍醫(yī)大學(xué)新橋醫(yī)院全軍呼吸內(nèi)科研究所/全軍呼吸病研究重點(diǎn)實(shí)驗(yàn)室;瀘州醫(yī)學(xué)院附屬醫(yī)院呼吸內(nèi)一科;四川省瀘州市第二人民醫(yī)院功能科;
【分類號(hào)】：R563.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 梁振宇;蔡紹曦;佟萬(wàn)成;趙海金;;肺栓塞首診失誤原因分析[J];南方醫(yī)科大學(xué)學(xué)報(bào);2009年03期

2 楊向華;;肺栓塞2例誤診分析[J];吉林醫(yī)學(xué);2010年12期

3 張昌榮;;誤診肺栓塞1例分析[J];臨床肺科雜志;2011年07期

4 蔡蓉;羅勇;;重癥肺炎合并多發(fā)肺栓塞一例誤診反思[J];臨床誤診誤治;2011年01期

5 蔣進(jìn)軍;白春學(xué);;綜合性醫(yī)院181例肺血栓栓塞癥的臨床分析[J];上海醫(yī)學(xué);2009年07期

6 張春;;急性肺動(dòng)脈栓塞誤診為急性冠脈綜合征25例臨床分析[J];醫(yī)學(xué)理論與實(shí)踐;2012年04期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王紅陽(yáng);劉颯;高愛(ài)麗;李琳;戈艷蕾;李球兵;郭霞;;肺栓塞臨床特征對(duì)比分析研究[J];重慶醫(yī)學(xué);2012年28期

2 吳曉馳;周恩飛;羅勇;章敬玉;陸惠昌;;住院患者慢性阻塞性肺疾病相關(guān)誤診原因分析及對(duì)策[J];臨床誤診誤治;2011年11期

3 潘唐超;;急性肺栓塞急診及時(shí)診斷和治療對(duì)患者療效及預(yù)后的影響[J];海南醫(yī)學(xué)院學(xué)報(bào);2012年08期

4 姚欣;張林紅;胡波;牛月海;王振國(guó);張樹峰;;利奈唑胺聯(lián)合莫西沙星治療重癥肺炎的觀察與護(hù)理[J];臨床合理用藥雜志;2012年28期

5 劉t，

本文編號(hào)：2391949