17例青年肺栓塞患者误诊原因分析  

Analysis of the Causes of Clinical Misdiagnosis of Pulmonary Embolism in 17 Young Patients

作　　者：梅周芳[1] 王张生[2] 施天昀 都勇[1] 何炜[1] 揭志军[1] MEI Zhou-fang WANG Zhang-sheng SHI Tian-yun DU Yong HE Wei JIE Zhi-jun(Shanghai Fifth People＇s Hospital Affiliated to Fudan University, 1.Respiratory Medicine Internal Medicine-Cardiovascular Department,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院呼吸内科,上海200240 [2]复旦大学附属上海市第五人民医院心内科,上海200240

出　　处：《中西医结合心血管病电子杂志》2016年第35期140-141,共2页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

基　　金：复旦大学附属上海市第五人民医院曙光青年科研基金(2013YSGQN02)

摘　　要：目的分析青年患者急性肺栓塞的临床特点及诊断方法,以减少误诊。方法对我院17例青年急性肺栓塞的临床资料进行回顾性分析,并复习相关文献。结果肺栓塞临床症状多种多样,缺乏特异性,临床医生对肺栓塞的认识不足,17例青年急性肺栓塞患者中,误诊为肺炎11例,肺结核3例,结核性胸膜炎1例,肺脓肿1例,肋软骨炎1例。结论肺栓塞临床上容易误诊,尤其青年患者的肺栓塞更加容易误诊,虽然绝大部分患者没有高危因素,仍应高度警惕肺栓塞可能,胸部CTPA(胸部CT肺动脉造影)检查对诊断有重要意义。Objective To analyze the clinical characteristics of pulmonary embolism in young patients and its diagnosis methods,so as to reduce misdiagnosis.Methods Seventeen cases of pulmonary embolism in our hospital was retrospectively analyzed, and relevant literatures were reviewed.Results Pulmonary embolism clinical symptoms varied,lack of specificity, clinicians lack understanding of pulmonary embolism,17 cases of young patients with acute pulmonary embolism, misdiagnosis pneumonia in 11 cases,3 cases of pulmonary tuberculosis,1 case of tuberculous pleurisy,lung abscess in 1 cases, costal chondritis in 1 case.Conclusion Pulmonary embolism is easy to be misdiagnosed,especially in young patients with pulmonary embolism is more prone to misdiagnosis, although the vast majority of patients with no risk factors,should be highly alert to the possible pulmonary embolism.Chest CTPA（chest CT pulmonary angiography） examination have important significance in diagnosis of pulmonary embolism.

关 键 词：急性肺栓塞 肺炎 胸痛 

分 类 号：R563.5[医药卫生—呼吸系统]