老年肺血栓栓塞症患者延迟诊断率及其原因分析  

Delayed diagnosis of pulmonary thromboembolism in the elderly and its reasons

作　　者：孙健[1] 王强[1] 丁晓倩[1] 孙勇[1] 徐涛[1] 

机构地区：[1]青岛大学附属医院呼吸科,266000

出　　处：《中华老年心脑血管病杂志》2016年第12期1239-1242,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年人肺血栓栓塞症（pulmonary thromboembolism, PTE）的延迟诊断率及其原因分析。方法回顾性分析2014年1月～2016年3月在我院接受治疗的140例PTE患者，所有患者均经螺旋CT肺动脉造影（computer tomography pulmonary angiography,CTPA）或肺灌注／通气（ventilation-perfusion ratio, V/Q）显像明确诊断。根据年龄将患者分成2组：老年组（≥65岁）80例，非老年组（〈65岁）60例，老年组根据是否存在诊断延迟又进一步分为延迟组23例、非延迟组57例，记录入组患者临床特点并进行分析。结杀老年组平均确诊时间、延迟诊断率明显高于非老年组[（4．15±5．26）h vs（2．52±3．91）h，P=0．030；（28．75％vs 11．67％，P=0．021）]。延迟组冠心病（52．2％vs26．3％，P=0．037）及慢性阻塞性肺部疾病（43．5％vs 10．5％，P=0．002）比例明显高于非延迟组。结论老年PTE患者平均确诊时间、延迟诊断率明显高于非老年组，与其伴随基础疾病多，临床症状不典型且易于混淆有关。Objective To study the delayed diagnosis of pulmonary thromboembolism （PTE） in the elderly and its reasons. Methods One hundred and forty PTE patients who underwent CTPA and V/Q in our hospital from January 2014 to March 2016 were divided into ≥65 years old group （n=80） and ≥65 years old group （n=60）. The patients in ≥65 years old group were further divided into delayed diagnosis group （n= 23） and non-delayed diagnosis group （n= 57）. Their clinical characteristics were analyzed. Results The average diagnosis time of PTE was significantly longer,the delayed diagnosis rate of PTE was significantly higher in ~65 years old group than in 65 years old group （4.15±5.26 h vs 2.52±3.91 h,P=0. 030;28. 75% vs 11.67%,P=0. 021）. The incidence of coronary heart disease and chronic obstructive pulmonary disease was signifi- cantly higher in deilayed diagnosis group than in non-delayed diagnosis group （52.2% vs 26.3%, P=0. 037;43.5% vs 10.5%,P=0. 002）. Conclusion The average diagnosis time is significantly longer and the delayed diagnosis rate is significantly higher in ~65 years old PTE patients than in 65 years old PTE patients,which are related with its atypical clinical symptoms.

关 键 词：肺栓塞 肺动脉 血管造影术 早期诊断 

分 类 号：R563.5[医药卫生—呼吸系统]