中国全科医学2011，Vol.14Issue(1)：96-98,3.
急性肺栓塞患者76例诊治分析
Diagnosis and Treatment of Acute Pulmonary Embolism:A clinical report of 76 cases
李银平 1华琦 2秦俭 1范振兴2
作者信息
- 1. 100053北京市,首都医科大学宣武医院急诊科
- 2. 首都医科大学宣武医院心脏科
- 折叠
摘要
Abstract
Objective To study the clinical characteristics of acute pulmonary embolism ( APE ), and to analyze the procedure of its correct diagnosis , reasons for misdiagnosis and how to improve the diagnosis. Methods The predisposing factors , clinical presentations , laboratory examinations, treatment and outcome of 76 inpatients with APE in Xuanwu Hospital from January 2008 to June 2010 were analyzed retrospectively. Results The prevalence of APE was higher at the age of 60 -79 years, most of the patients had the risk factors related to PE. The misdiagnosis rate was 38. 2％ at the first diagnosis. Among the 21 misdiagnosed patients Geneva scores showed that 86. 2％ were of moderate or high possibility to have APE. The symptoms of APE were varied. the most common symptoms were dyspnea, chest pain, and syncope. The common ECG findings of APE were the S Ⅰ QⅢ TⅢ pattern ( 73. 7％ ). and T wave inversion in precordial leads V1 through V4 ( 36. 8％ ). There were 58. 8％ patients who had right ventricular enlargement on ultrasound cardiogram, 48. 5％ who had pulmonary hypertension , and 39. 7％ who had enlargement of right ventricle. Blood gas analysis showed hypoxemia in 55. 7％ , increase of D - dimer in 86. 1％ . Among the 76 patients, 32 patients were administered thrombolytics, there was one death and no severe haemorrhagia phenomenon during thrombolysis therapy. Conclusion The incidence of APE is related to the predisposing factors, the manifestations are many and varied so misdiagnosis is very likely. Geneva score for suspicious APE is helpful for differential diagnosis. Thrombolysis therapy is effective and safe in high - risk APE.关键词
急性肺栓塞/误诊/Geneva评分分类
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李银平,华琦,秦俭,范振兴..急性肺栓塞患者76例诊治分析[J].中国全科医学,2011,14(1):96-98,3.
