CAJ | 학술논문

目的：探讨肺栓塞的诊断方法，分析常见误诊原因，提高对肺栓塞的认识，降低误诊、误治。方法：收集了30例肺栓塞患者的临床表现、实验室资料及误诊情况，对误诊原因进行分析。结果：肺栓塞临床表现缺乏特异性，临床医生，尤其是部分外科医生对该病认识不足，故误诊率高。30例病例误诊肺炎11例，肺结核4例，胸膜炎3例，慢性阻塞性肺病2例，肺心病2例，急性冠脉综合征5例，急性左心衰2例，腰椎间盘突出症1例。结论：肺栓塞早期临床诊断有一定困难，临床医生应提高对病症的认识，对有高危因素患者新近出现气促、胸痛、咯血、呼吸困难和新发肺部浸润影，经治疗症状无缓解，应考虑肺栓塞可能，尽早完善CT肺动脉造影检查，减少误诊、误治。
목적：탐토폐전새적진단방법，분석상견오진원인，제고대폐전새적인식，강저오진、오치。방법：수집료30례폐전새환자적림상표현、실험실자료급오진정황，대오진원인진행분석。결과：폐전새림상표현결핍특이성，림상의생，우기시부분외과의생대해병인식불족，고오진솔고。30례병례오진폐염11례，폐결핵4례，흉막염3례，만성조새성폐병2례，폐심병2례，급성관맥종합정5례，급성좌심쇠2례，요추간반돌출증1례。결론：폐전새조기림상진단유일정곤난，림상의생응제고대병증적인식，대유고위인소환자신근출현기촉、흉통、각혈、호흡곤난화신발폐부침윤영，경치료증상무완해，응고필폐전새가능，진조완선CT폐동맥조영검사，감소오진、오치。
Objective:To explore the diagnostic method of pulmonary embolism and analyze the reason of misdiagnosis, in order to improve the awareness of pulmonary embolism and reduce misdiagnosis and mistreatment. Methods:Clinical manifestation, laboratory data and the status about misdiagnosis of pulmonary embolism were collected to analyze the reason of 30 cases of misdiagnosis in the People's Hospital of Baoshan. Results: Clinicians, especially the surgeons' insufficient understanding of the specific clinical symptoms of pulmonary embolism led to the high rate of misdiagnosis. There were 11 cases misdiagnosed as pneumonia; 4 cases of pulmonary tuberculosis; 3 cases of pleural effusion, 2 cases of chronic obstructive pulmonary disease; 2 cases of pulmonary heart disease; 5 cases of acute coronary syndrome; 2 cases of acute left heart failure; 1 cases of lumbar disc herniation. Conclusion: The early clinical diagnosis of pulmonary embolism was difficult, and clinicians should improve their understanding of this disease. Pulmonary embolism should be considered when patients showed symptom with chest pain, rough breathing, hemoptysis, dyspnea and new pulmonary infiltrates but not improved after treatment. Meanwhile, CT pulmonary artery angiography should be improved to reduce misdiagnosis and mistreatment.