摘要
目的 :了解肺栓塞诊断现况。 方法 :本院收治的 6 7例肺栓塞患者 ,分为急性肺栓塞组 (2 0例 ) ,慢性肺栓塞组 (4 7例 ) ,回顾性分析入院前确诊率、确诊时间、确诊时是否出现持续性肺动脉高压以及常见误诊疾病。 结果 :1患者入院前确诊率 2 3.9% ,急性肺栓塞为 5 5 .0 % ,慢性肺栓塞为 10 .6 % ;肺栓塞合并下肢静脉血栓形成35 .1% ,单纯肺栓塞为 6 .7%。 2慢性肺栓塞平均确诊时间为 3.15年 (最长为 16年 ) ,慢性肺栓塞组在确诊时 78.3%患者已经形成中、重度持续性肺动脉高压 ;急性肺栓塞患者确诊时仅 35 .0 %仍在有效溶栓时间窗内 (≤ 2周 )。 3 2 0 .0 %急性肺栓塞患者入院前诊断不明 ,2 0 .0 %误诊为急性心肌梗塞或心绞痛 ,5 .0 %误诊为慢性阻塞性肺部疾病急性发作期 ;44 .7%慢性肺栓塞患者长期诊断不明 ,2 1.3%误诊为冠心病、心肌病或心力衰竭 ,17.0 %误诊为原发性肺动脉高压 ,6 .4%误诊为慢性阻塞性肺部疾病。 结论 :漏诊、误诊以致延误病情仍然是肺栓塞不容忽视的重要问题。
Objective:To retrospectively analyze the current status of pulmonary embolism diagnosis. Methods:Patients with pulmonary embolism (PE) were admitted to our hospital.Data from the patients during hospitalization were collected and analyzed. Results:①The confirmed diagnosis rate of PE before admission was 23 9% (16/67),exactly,55 0% (11/20) in acute PE and 10 6% (5/47) in chronic PE.②The average time between the onset and the confirmed diagnosis of chronic PE was 3 15 years.When the diagnosis was confirmed,78 3% of the patients had developed persistent pulmonary artery hypertension moderate or severe and only 35%of the patients with acute PE were still in the time belt for thrombolytic therapy.③Before admission to our hospital,the diagnosis of acute PE was not definitive in 20 0% (4/20),mistaken for acute myocardial infarction or angina pectoris in 20 0% (4/20) and for chronic obstructive pulmonary disease with acute onset in 5 0% (1/20).The diagnosis of chronic PE was not definitive in 44 7%(21/47) before admission,with 21 3% (10/47) misdiagnosed as coronary arterial disease,cardiomyopathy or chronic heart failure,17 0% (8/47) as primary pulmonary hypertension,and 6 4% (3/47) as chronic obstructive pulmonary disease. Conclusions:Although new diagnostic methods have been increasingly introduced,the misdiagnosis rate of PE is still high.The diagnosis of pulmonary embolism remains a problem.
出处
《中国循环杂志》
CSCD
北大核心
2001年第1期44-45,共2页
Chinese Circulation Journal
