摘要
Abstract
Objective To analyze the clinical characteristics and causes of misdiagnosis in patients with acute pulmo-nary embolism(APE)and pulmonary infarction combined with hemoptysis at ultra-high altitude,so as to improve the diagno-sis and treatment of APE.Methods The clinical data of a patient with APE and pulmonary infarction combined with hemop-tysis misdiagnosed as pneumonia at ultra-high altitude in May 2024 were retrospectively analyzed and a literature review was performed.Results The patient was admitted with cough and sputum for 15 days,left chest pain,shortness of breath,and hemoptysis for 1 week,which were aggravated for 3 days.The patient was an excavator driver who had been working in an ultra-high altitude area for one month.The patient was treated in several medical institutions and misdiagnosed as pneumonia combined with hemoptysis.Anti-infection and symptomatic treatment were given,but the symptoms gradually worsened.Final-ly,CT pulmonary angiography confirmed APE with pulmonary infarction combined with hemoptysis.The misdiagnosis lasted 1 week.After Enoxaparin anticoagulation and symptomatic treatment,his condition improved and he was discharged.At 6 months after discharge,the patient was followed up by telephone,and the symptoms had completely disappeared at 3 months after routine anticoagulant treatment.Conclusion For patients with hemoptysis,chest pain and dyspnea in ultra-high altitude areas,clinicians should be alert to the possibility of secondary pulmonary infarction caused by APE.For patients with APE combined with hemoptysis,individualized treatment plans should be developed according to factors such as the cause and the amount of hemoptysis.关键词
肺栓塞/肺梗死/咯血/超高海拔/误诊/肺炎/CT肺动脉造影/鉴别诊断Key words
Pulmonary embolism/Pulmonary infarction/Hemoptysis/Ultra-high altitude/Misdiagnosis/Pneumonia/CT pulmonary arteriography/Differential diagnosis分类
医药卫生
