心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2014年
3期
339-340
,共2页
肺栓塞%心电描记术%老年医学
肺栓塞%心電描記術%老年醫學
폐전새%심전묘기술%노년의학
Pulmonary embolism%Electrocardiography%Geriatrics
目的：探讨老年人肺栓塞的临床特点及诊断。方法：对56例老年人肺栓塞的临床特点、心电图及诊断进行总结分析。结果：老年肺栓塞患者最常见症状为劳力性呼吸困难，有39例（69.6％），心电图有特征性变化12例（21.4％），56例患者行多层螺旋CT肺动脉造影，均发现肺动脉内血栓（100％）；核素肺通气灌注扫描38例，提示有肺灌注与通气显像不匹配32例（84.2％）；下肢深静脉超声发现静脉血栓26例（46.4％）。误诊情况：误诊26例（46.4％），误诊：呼吸系统疾病14例（53.8％），其中感染性休克8例，肺部感染6例；误诊为循环系统疾病12例（46.2％），其中急性冠状动脉综合征5例，心力衰竭4例，心源性休克3例。结论：老年人肺栓塞最常见症状为劳力性呼吸困难，少数患者心电图有特征性变化，肺动脉造影为主要确诊手段。
目的：探討老年人肺栓塞的臨床特點及診斷。方法：對56例老年人肺栓塞的臨床特點、心電圖及診斷進行總結分析。結果：老年肺栓塞患者最常見癥狀為勞力性呼吸睏難，有39例（69.6％），心電圖有特徵性變化12例（21.4％），56例患者行多層螺鏇CT肺動脈造影，均髮現肺動脈內血栓（100％）；覈素肺通氣灌註掃描38例，提示有肺灌註與通氣顯像不匹配32例（84.2％）；下肢深靜脈超聲髮現靜脈血栓26例（46.4％）。誤診情況：誤診26例（46.4％），誤診：呼吸繫統疾病14例（53.8％），其中感染性休剋8例，肺部感染6例；誤診為循環繫統疾病12例（46.2％），其中急性冠狀動脈綜閤徵5例，心力衰竭4例，心源性休剋3例。結論：老年人肺栓塞最常見癥狀為勞力性呼吸睏難，少數患者心電圖有特徵性變化，肺動脈造影為主要確診手段。
목적：탐토노년인폐전새적림상특점급진단。방법：대56례노년인폐전새적림상특점、심전도급진단진행총결분석。결과：노년폐전새환자최상견증상위로력성호흡곤난，유39례（69.6％），심전도유특정성변화12례（21.4％），56례환자행다층라선CT폐동맥조영，균발현폐동맥내혈전（100％）；핵소폐통기관주소묘38례，제시유폐관주여통기현상불필배32례（84.2％）；하지심정맥초성발현정맥혈전26례（46.4％）。오진정황：오진26례（46.4％），오진：호흡계통질병14례（53.8％），기중감염성휴극8례，폐부감염6례；오진위순배계통질병12례（46.2％），기중급성관상동맥종합정5례，심력쇠갈4례，심원성휴극3례。결론：노년인폐전새최상견증상위로력성호흡곤난，소수환자심전도유특정성변화，폐동맥조영위주요학진수단。
Objective:To explore clinical characteristics and diagnosis in aged patients with pulmonary embolism. Methods:The data of electrocardiogram (ECG),clinical characteristics and diagnosis were summarized and ana-lyzed in 56 aged patients with pulmonary embolism.Results:The most frequent symptom was exertional dyspnea (69.6%).ECG had characteristic changes in 12 patients (21.4%).All 56 patients received multi-slice spiral CT pulmonary arteriography,and thrombus within pulmonary artery was found in all patients (100%);38 cases re-ceived nuclide lung ventilation perfusion scanning,the results were 32 cases (84.2%)with mismatching pulmonary perfusion and ventilation imaging;Ultrasound examine found there were phlebothrombosis in deep vein of lower limb of 26 cases (46.4%).Misdiagnosis:The 26 cases (46.4%)were misdiagnosed.A total of 14 cases (53.8%) were misdiagnosed as respiratory system diseases,including eight cases of infectious shock and six cases with pulmo-nary infection;12 cases (46.2%)were misdiagnosed as circulatory system diseases,including five cases of acute cor-onary syndrome,four cases of heart failure and three cases of cardiogenic shock.Conclusion:The most frequent symptom is exertional dyspnea in aged patients with pulmonary embolism;ECG has characteristic changes only in few patients;the pulmonary arteriography is major diagnosis method.
