CAJ | 학술논문

目的：分析以晕厥为首发症状的肺栓塞漏诊原因，提高对该病的认识。方法对17例以晕厥为首发症状的老年人肺栓塞漏诊的症状、体征、辅助检查进行分析，确诊肺栓塞后，根据病情予尿激酶溶栓，低分子肝素钙、华法林等抗凝治疗。结果17例患者均病情改善，无再晕厥发作。结论老年人出现晕厥时，除了要考虑常见的心脑疾患以外，还要考虑肺栓塞的可能，常规检查心电图、D-二聚体，并行彩超、血气分析、增强螺旋CT、肺动脉造影等检查，从而减少肺栓塞漏诊的发生。
목적：분석이훈궐위수발증상적폐전새루진원인，제고대해병적인식。방법대17례이훈궐위수발증상적노년인폐전새루진적증상、체정、보조검사진행분석，학진폐전새후，근거병정여뇨격매용전，저분자간소개、화법림등항응치료。결과17례환자균병정개선，무재훈궐발작。결론노년인출현훈궐시，제료요고필상견적심뇌질환이외，환요고필폐전새적가능，상규검사심전도、D-이취체，병행채초、혈기분석、증강라선CT、폐동맥조영등검사，종이감소폐전새루진적발생。
Objective To analyze the symptoms , signs and assistant examinations of aged syncope patients with missed diagnosis of pulmonary embolism ( PE) ,find out the possible diagnostic information ,sum up experience ,in order to reduce missed diagnosis rate .Methods According to disease condition , patients with diagnosed PE , re-ceived anticoagulation therapy ,including low molecular weight heparin calcium injection thrombolytic therapy with in -travenous injection of urokinase and oral administration of the anticoagulant warfarin .Results The disease condition was improved in 17 patients , all patients did not have syncopal attack .Conclusion In addition to consider common cerebrovascular disease , it is necessary to improve the diagnosis consciousness of PE for aged patients when syncope occurs.Routine examinations including electrocardiogram ,D-dimer,color Doppler ultrasound ,blood gas analysis ,spi-ral CT,pulmonary angiography can reduce the occurrence of missed diagnosis of PE .