CAJ | 학술논문

目的：探讨急性冠状动脉综合征与肺栓塞的诊断与鉴别，为降低误诊率提供依据。方法对18例被误诊为急性冠脉综合征的急性肺栓塞患者误诊情况与临床特点进行回顾分析。结果18例中胸痛10例，呼吸困难14例，D-diner（D-二聚体）＞520μg/L；患者血气分析均为低氧血症；11例患者心电图ST-T改变。考虑诊断为急性肺栓塞原因：8例胸痛伴有严重低氧血症，6例冠状动脉造影结果正常，4例给予冠心病常规治疗无效。结论因呼吸困难、胸痛被初诊为急性冠脉综合征的患者，如果临床资料不足以确诊时，特别对于冠心病常规治疗无效或低氧血症严重时，应考虑诊断为急性肺栓塞并行早日检查确诊。
목적：탐토급성관상동맥종합정여폐전새적진단여감별，위강저오진솔제공의거。방법대18례피오진위급성관맥종합정적급성폐전새환자오진정황여림상특점진행회고분석。결과18례중흉통10례，호흡곤난14례，D-diner（D-이취체）＞520μg/L；환자혈기분석균위저양혈증；11례환자심전도ST-T개변。고필진단위급성폐전새원인：8례흉통반유엄중저양혈증，6례관상동맥조영결과정상，4례급여관심병상규치료무효。결론인호흡곤난、흉통피초진위급성관맥종합정적환자，여과림상자료불족이학진시，특별대우관심병상규치료무효혹저양혈증엄중시，응고필진단위급성폐전새병행조일검사학진。
Objective To explore the acute coronary syndrome and the diagnosis of pulmonary embolism and to identify and provide the basis for reduce the misdiagnosis rate.Methods 18 cases misdiagnosed as acute coronary syndrome in patients with acute pulmonary embolism of misdiagnosis and clinical features were analyzed retrospectively.Results 18 cases, 10 cases of chest pain, dyspnea, 14 cases of D - like> 520 mu g/L; Blood gas analysis were hypoxemia; 11 patients electrocardiogram ST -t change. Consider a diagnosis of acute pulmonary embolism: 8 cases of chest pain associated with severe hypoxemia, 6 cases of normal coronary angiography results, 4 cases were given routine therapy and coronary heart disease.Conclusion Because of the dififculty in breathing, chest pain was ifrst diagnosis for patients with acute coronary syndrome, if clinical data are insufifcient to diagnosis, especially for coronary heart disease (CHD) conventional treatment is invalid or severe hypoxemia, consideration should be given a diagnosis of acute pulmonary embolism in parallel, diagnosed at an early date.