肺栓塞误诊分析

目的分析肺栓塞误诊原因，探讨提高肺栓塞诊断率的方法。方法回顾性分析2010年12月至2016年4月22例肺栓塞误诊患者的临床资料。结果22例患者误诊为肺炎6例，急性冠脉综合征5例，心力衰竭5例，慢性阻塞性肺疾病急性发作2例，脑血管意外2例，感染性休克1例，胸膜炎1例。结论肺栓塞的临床表现多样缺乏特异性，同时临床医师对该病诊断意识不足是导致误诊的主要原因。肺栓塞致残率、病死率高，临床医师应尽可能提高肺栓塞的诊断率，改善预后。

Objective To analysis the reasons of misdiagnosis of pulmonary embolism and explore the strategies of improving the diagnosis rate in pulmonary embolism. Methods Retrospectively analyzed the clinical data of 22 patients with pulmonary embolism which were misdiagnosed at first, from December 2010 to April 2016, in our hospital. Results 22 cases of pulmonary embolism were misdiagnosed as pneumonia （ 6 cases ） , acute coronary syndromes （ 5 cases ） , heart failure （ 5 cases ） , acute exacerbation period of chronic obstructive pulmonary disease （ 2 cases ） , cerebrovascular accident （ 2 cases ） , septic shock （ 1 case ） , pleurisy （ 1 case ） at first. Conclusion Clinical manifestations of pulmonary embolism are diverse and non-specific and clinicians＇ diagnosis consciousness of pulmonary embolism are not enough. They are the main reasons of misdiagnosis. Early diagnosis and treatment can decrease the mortality and maimed rate of pulmonary embolism significantly.