67例肺栓塞患者相关临床资料分析

67 Examles pulmonary embolism patients are connected with the clinical material analysis

目的研究分析肺栓塞（PE）首诊、误诊状况，及确诊后有效干预（抗凝、溶栓）疗效，旨在提高对PE首诊确诊率，尽快实施有效治疗。方法通过对我科2001年8月-2006年8月67例PE病例研究，对被误诊患者一般情况，治疗及转归、死亡原因、误诊疾病进行回顾性分析。结果（1）67例PE患者，首诊误诊23例，误诊时间2h-3d。（2）PE患者经确诊后进行有效干预（抗凝、溶栓）组，有效率高于未干预（内科保守治疗）组。未干预组死亡原因主要为猝死、休克难以纠正等，干预组死亡原因为猝死、脑出血、休克等。（3）首次误诊疾病多达10余种，前3位依次是心力衰竭13例（56．5％）、冠心病6例（26．1％）、重症肺炎4例（17．4％）。结论（1）误诊原因与首诊医师对PE病情不能充分认识有关。（2）加强PE与心力衰竭、冠心病、重症肺炎的鉴别诊断能力。

Objective Research analysis of pulmonary embolism （PE） head examines the error diagnostic condition,and after the diagnosis the effective intervention （ prevents clotting, dissolves the hitch） the curative effect,is for the purpose of enhancing to PE head examines the diagnosis rate, implements the effective treatment as soon as possible. Methods Thtough in August,2001 -August,2006 67 examples PE case of illness studied to my btanch, to is misdiagnosed the patient ordinaty citcumstances,the treament and the extension turn over to,canse of death,error diagnostic disease carry on the review analysis. Results （ 1 ）67 exampoes PEpafients,the head examines misdiagnoses 23 examples,error diagnostic time is 2 hours 3 days. （2） The effectiveness of group that the PE patients carry on the effective intervention （prevents clotting,dissolves the hitch）after the diagnosis is higher than the group that the non - interverdon internal medicine department consetvative treament）. Non - intervention group cause of death is mainly sudden death, the shock correts with difficulty and so on. The intervention group cause of death is the suddn death,cerebtal hemorrhage,shock and so on. （3） Misdiagnses disease reach to10 kinds for the first dine, first 3 is the heart failure 13 examples （56.5%） ,coronary heart disease 6 examples（26.1% ） ,critically ill pneumonia 4 examples（ 17.4% ）. Conclusion （ 1 ） The error diagnositic reason is relevant to examines doctors who not to be able to know fully concerns of the PE condition. （2）Strengthens PE and the heart failure, coronary heart disease, critically ill pneumonial disrinction diagnosis ability.