临床误诊误治2018，Vol.31Issue(6)：10-12,3.DOI:10.3969/j.issn.1002-3429.2018.06.004
D-二聚体阴性肺栓塞四例误漏诊临床分析
Clinical Analysis of Misdiagnosis and Missed Diagnosis of Four Cases of Pulmonary Embolism with a Nega-tive D-Dimer
摘要
Abstract
Objective To summarize the clinical features of two cases of pulmonary embolism ( PE) with a negative D-dimer, and to analyze the causes of misdiagnosis and missed diagnosis. Methods The clinical data of 4 cases of PE with a negative D-dimer misdiagnosed as other diseases in our hospital were retrospectively analyzed. Re-sults In this group, 2 patients were admitted to hospital for dyspnea, and chest tightness, 1 admitted for lower limb edema, and pain associated with muscle fatigue, and 1 for cough, expectoration, and shortness of breath with daily activity. There was misdiagnosis of chronic obstructive pulmonary disease (n=2),coronary heart disease (n=1), and deep vein thrombosis (n=1). The duration of misdiagnosis was 3-10 d. All were diagnosed as PE with a nega-tive D-dimer based on spiral CT pulmonary angiography ( CTPA) , D-dimer detection and arterial blood gas analysis. After treatment with warfarin or low molecular weight heparin, they were discharged at stable conditions. All patients were followed up for 3-6 months, and the prognosis was favorable. Conclusion Improved understanding and differ-ential diagnosis of PE with a negative D-dimer helps to reduce or avoid misdiagnosis, and improve the diagnosis and treatment as well as prognosis.关键词
肺栓塞/误诊/肺疾病,慢性阻塞性/冠心病Key words
Pulmonary embolism/Misdiagnosis/Pulmonary disease,chronic obstructive/Coronary disease分类
医药卫生引用本文复制引用
雷松,李丽..D-二聚体阴性肺栓塞四例误漏诊临床分析[J].临床误诊误治,2018,31(6):10-12,3.基金项目
四川省卫生厅科研课题资助(120116) （120116）
