| 摘要: |
| ［摘要］ 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。 |
| 关键词: 肺栓塞 晕厥 漏诊 |
| DOI：10.3969/j.issn.1674-3806.2014.03.21 |
| 分类号:R 563 |
| 基金项目: |
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| Missed diagnosis of pulmonary embolism in aged patients with syncope: an analysis of 17 cases |
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LIN Dong-heng, HUANG Jian-long, ZHANG Zhi-yang, et al.
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Department of Internal Medicine, Anxi County Hospital, Fujian 362400,China
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| Abstract: |
| ［Abstract］ 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，received anticoagulation therapy,including low molecular weight heparin calcium injection thrombolytic therapy with intravenous 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,spiral CT,pulmonary angiography can reduce the occurrence of missed diagnosis of PE. |
| Key words: Pulmonary embolis（PE） Syncope Missed diagnosis |
