呼吸内科肺栓塞首次诊断延迟的危险因素与对策  

Diagnostic Delay of New Pulmonary Embolism in Department of Respiratory Medicine-risk Factors and Countermeasure

作　　者：王彰晖[1] 瞿跃进[1] 

机构地区：[1]厦门大学附属第一医院呼吸内科,福建厦门361003

出　　处：《中国卫生标准管理》2017年第18期36-39,共4页China Health Standard Management

摘　　要：目的明确呼吸内科肺栓塞首次诊断延迟的相关临床因素,寻找避免肺栓塞延迟诊断的方法。方法回顾性分析我院呼吸内科2008年1月1日—2016年12月31日出院的首次诊断肺栓塞患者的临床资料。72例患者被分为延迟诊断组28例、及时诊断组44例。用多元回归方法分析诊断延迟与临床参数的关系。结果感染(OR=12.226,95%CI:1.684~88.779)是肺栓塞诊断延迟的独立危险因素,血小板数(OR=0.992,95%CI:0.984~1.000)与诊断延迟负关联。急性肺栓塞临床可能性评估的简化Wells评分(t=2.620,P=0.011)可能导致诊断延迟。结论警惕感染患者的肺栓塞。用急性肺栓塞临床可能性评估的简化Geneva评分标准可能避免PE诊断延迟。Objective To identify clinical factors associated with delayed new diagnosis of pulmonary embolism （PE） in respiratory department and to find methods to avoid delayed diagnosis. Methods A retrospective observational study was performed at a department of respiratory medicine in an university affliated hospital. 72 patients who were newly diagnosed with PE from January 1, 2008 to December 31, 2016 were included and divided into Delayed Diagnosis Group （n=28） and Prompt Diagnosis Group （n=44）. Relationships between diagnostic delay and clinical parameters were tested using multivariate regression analysis. Results Infection （OR=12.226, 95%CI 1.684 ~ 88.779） and platelet （OR=0.992, 95%CI ： 0.984 ~ 1.000） were independent predictors of diagnostic delay. A simplified Wells score for assessment of PE clinical probability （t=2.620, P=0.011） was associated with diagnostic delay. Conclusion Pulmonologists should alert PE after infection. The simplifed revised Geneva score for assessment of PE clinical probability may help avoiding PE diagnostic delay in department of respiratory medicine.

关 键 词：呼吸内科 肺栓塞 诊断延迟 

分 类 号：R563[医药卫生—呼吸系统]