临床误诊误治2016，Vol.29Issue(3)：1-3,3.DOI:10.3969/j.issn.1002-3429.2016.03.001
呼吸困难在肺栓塞鉴别诊断中的作用(附气胸并肺栓塞1例)
The Identification of Dyspnea in the Diagnosis of Pulmonary Embolism:Based on a Rare Case of Pulmonary Embol-ism with Pneumothorax
李润生 1蔡礼鸣 1张芳1
作者信息
- 1. 214062 江苏 无锡,江南大学附属医院呼吸科
- 折叠
摘要
Abstract
Objective To discuss the value of dyspnea in the diagnosis of pulmonary embolism. Methods Clinical data of one rare case of pneumothorax with pulmonary embolism was retrospectively analyzed in our hospital, and the relevant literature was reviewed. Results The patient, who had been previously diagnosed as right-sided pneumothorax by the local town clinic for chest tightness and shortness of breath for 3 days, was admitted to our hospital and given a treatment of chest drain. But following a full re-expansion, he still had tachypnoea. Further examinations produced a negative result for diseases leading to dyspnea, such as heart failure and bronchial asthma. Meanwhile, the D-dimer test report showed elevated values, computed tomographic pulmonary angiography demonstrated bilateral patchy atelectasis in the lower lobes and color Doppler disclosed thrombi in medial gastrocnemius veins. Therefore, the patient was confirmed as having pulmonary embolism with deep vein thrombosis of the lower limbs according to his clinical features. After anticoagulant therapy, the patient's condition was improved and he was discharged from the hospital. Conclusion Dyspnea is the most common symptom of pulmonary em-bolism, characterized by suddenness and nonspecificity. Careful identification and high alert to pathogeny of dyspnea are con-ducive to the early differential diagnosis of pulmonary embolism in lowrisk population.关键词
肺栓塞/呼吸困难/气胸/漏诊Key words
Pulmonary embolism/Dyspnea/Pneumothorax/Missed diagnosis分类
临床医学引用本文复制引用
李润生,蔡礼鸣,张芳..呼吸困难在肺栓塞鉴别诊断中的作用(附气胸并肺栓塞1例)[J].临床误诊误治,2016,29(3):1-3,3.
