医院近10年肺栓塞诊治现状分析  

Analysis of diagnosis and treatment of pulmonary embolism in a second-class hospital in recent 10 years

作　　者：胡利明[1] 王丽红[2] 孙艺青 田英平[3] HU Liming;WANG Lihong;SUN Yiqing(Department of Respiratory Diseases,Anguo City Hospital,Hebei,Anguo 071200,China;不详)

机构地区：[1]河北省安国市医院呼吸科,071200 [2]承德医学院附属医院血液内科 [3]河北医科大学第二医院急诊科

出　　处：《河北医药》2021年第9期1417-1419,1423,共4页Hebei Medical Journal

基　　金：保定市科学技术研究与发展计划项目(编号:2041ZF002)。

摘　　要：目的评估医院近10年肺栓塞(pulmonary embolism,PE)的诊治现状。方法检索医院2010年1月至2020年1月所有入院病例,筛选出院第一诊断或次要诊断为PE的患者作研究对象,搜集PE患者的一般资料、基础疾病、高危因素、临床症状、影像学表现、实验室检查和预后等资料进行分析。结果共43例PE患者,符合纳入标准41例,平均年龄(67.73±10.47)岁,其中误诊患者23例,常见误诊疾病为肺炎、冠心病、心力衰竭和气促原因待查。根据首诊是否误诊将患者分为首诊误诊组和首诊确诊组,发现首诊误诊组患者年龄明显高于首诊确诊组患者年龄(P<0.05),但性别、基础疾病、临床症状差异无统计学意义(P>0.05);医院心动图、血气分析、D-二聚体执行能力较高,但2组在心电图、血气分析、D-二聚体检查差异无统计学意义(P>0.05);且发现首诊误诊组住院时间明显高于首诊确诊组,差异有统计学意义(P<0.05),但2组患者的预后无统计学差异(P>0.05)。结论PE患者临床症状多不典型,及时有效的辅助检查及鉴别诊断对PE的诊断至关重要,临床医生需熟悉PE的危险因素、临床症状,通过临床可行性评分对疑似PE患者做出及时有效的辅助检查及鉴别诊断,降低PE误诊率。Objective To investigate the current situation of diagnosis and treatment of pulmonary embolism(PE)in our hospital in recent 10 years.Methods Of the patients who were treated in our hospital from January 2010 to January 2020,the patients with PE as the first or secondary diagnosis in discharge from hospital were enrolled as the research objects.The general data,basic diseases,high risk factors,clinlcal symptom,imaging findings,laboratory examination and prognosis of patients were collected and analyzed.Results A total of 43 patients were diagnosed as PE,of whom,41 patients were enrolled in the study,with an average age of(67.73±10.47)years.Among them,23 cases were misdiagnosed.The common misdiagnosis diseases were pneumonia,coronary heart disease,heart failure and shortness of breath.According to whether the first diagnosis was misdiagnosed,the patients were divided into misdiagnosis group and definite diagnosis group.It was found that the age of patients in misdiagnosis group was significantly higher than that in definite diagnosis group(P<0.05).However there were no significant differences in patient’s gender,basic diseases and clinical symptoms as well as the examination results of ECG,blood gas analysis and D-dimer levels between the two groups(P>0.05).Moreover the hospitalization time in misdiagnosis group was significantly higher than that in definite diagnosis group(P<0.05),but there was no significant difference in the prognosis of patients between the two groups(P>0.05).Conclusion The clinical symptoms of patients with pulmonary embolism are atypical.Timely and effective auxiliary examination and differential diagnosis are quite important for the diagnosis of PE.Clinicians should be familiar with the risk factors and clinical symptoms of PE,and to make timely and effective diagnosis,so as to reduce the misdiagnosis rate of PE.

关 键 词：肺栓塞 误诊 鉴别诊断 预后 

分 类 号：R195[医药卫生—卫生统计学]