急性肺栓塞46例临床分析

Analysis in 46 cases of acute pulmonary embolism

目的探讨APE临床特征及规范化诊断、治疗的特点,降低误诊率,提高治愈率。方法对我院1989年3月-2007年7月住院的46例急性肺栓塞病例临床特征、诊断及治疗情况进行回顾性分析。结果46例患者病因分别为:下肢深静脉血栓、外科手术、长期卧床、恶性肿瘤、冠心病、妊娠与分娩。其中入院首诊7例,占15%,误诊11例占24%,其他病例是在治疗过程中明确诊断。误诊原因为发病急骤,临床表现不典型;医务人员对本病认识警觉性不高,实验室检查水平受限。死亡5例,均发生在入院后24h-72h溶栓未进行时。病死率达11%。结论对病因明确、突然发病的疑似病例要提高警惕,及时进行有关实验室检查和影像学检查,综合分析,正确规范地诊断和治疗,提高治愈率。

Objective To explore the clinical features of acute pulmonary embolism's diagnosis and treatment. Reduce the misdiagnosis rate and improve the cure rate. Methods To our hospital,from March,1989 to July,2007 in the forty-six Pulmonary embolism cases of clinical features and treatment to retrospective analysis. Results 46 cases were cause bower limb deep Vein Thrombosis,Surgery,Bed,Coronary Heart Disease,Pregnancy,Delivery. One admitted attending the first 7 cases,accounting for 15%,11 cases of misdiagnosis,accounting for 24%.Other cases in the course of treatment were a clear diagnosis. Misdiagnosis due to incidence quickly,clinical manifestations of atypical,lack of awareness and vigilance ,check the level of support limited ,5 cases to death,occur 24-72 hours after admission thrombolysis have not been at mortality rate of 11%.Conclusion We should pay attention to the patients with clear cause and sudden onset. Taking lab exam and imaging examination promptly and comprehensive analysis,diagnosis and treatment standardization,which would improve the cure rate.