急性肺栓塞诊断现状分析及改进策略

Analysis of the Diagnostic Methods of the Acute Pulmonary Embolism and Study of Further Strategy about Improving the Diagnostic Level

目的:分析急性肺栓塞的诊断现状,探讨提高诊断水平的方法和途径。方法:对39例急性肺栓塞患者根据其诊断依据进行分类统计。结果:单纯依靠临床症状体征做出诊断的占23％,结合常用实验室检查结果做出诊断的占28.2％,结合影像学结果做出诊断的占38.5％,病理诊断占10.3％。结论:目前临床表现仍是诊断急性肺栓塞的主要依据,选择何种辅助检查常由医生根据个人经验而定,因而误诊、漏诊率仍很高。临床医生只有提高诊断意识、充分了解各种辅助检查的作用,并根据诊断步骤正确选用才能提高急性肺栓塞的诊断水平。

Objective: To analyze the diagnostic actuality of acute pulmonary embolism and search for new ways to improve the diagnostic level. Methods: 39 patients suffering from acute pulmonary embolism were classified according to their own diagnostic methods. Results: The cases were diagnosed as the acute pulmonary embolism by 23% according to the symptoms and physical signs, by 28.2% according to the basic laboratorial results, by 38.5% according to the video results and by 10.3% according to the pathologic results. Conclusions: Because doctors diagnose acute pulmonary embolism mostly according to patients' clinical characters and choose assistant examinations depending on their experience, the rate of misdiagnosis and missed diagnosis is high. In order to increase the rate it is necessary to raise the consciousness of diagnosis, comprehend the use of every examinations and correctly choose them in the light of diagnostic process.