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慢性肺心病并发肺水肿为临床急重症,错误的诊断往往导致抢救的失败。我院近10年来收治住院的286例慢性肺心病中,46例并发肺水肿,其中误诊24例,现就误诊原因作一初步分析。临床资料 24例误诊病人均因慢性肺心病急性发作进院,并符合1977年全国肺心病会议制定的诊断标准。男性18例,女性6例,年龄48～76岁,平均57岁。呼衰9例,心衰7例,呼衰并心衰8例。伴有高心、冠心等左室病变者7例,无伴发病者17例。并发肺水肿时的临床表现,端坐呼吸8例,发作性呼吸困难、咳白色或粉红色泡沫痰10例,哮喘样发作6例。体检双肺满布湿性啰音15例,双肺满布哮鸣音及双肺底湿性啰音9例。血气分析PaO_2<6.65kPa 11例,<7.98kPa 6例,>7.98 kPa 7例;PaO_2>5.98kPa<7.28kPa 14例,>7.28kPa<8.64APa 8例,>8.64kPa 2例。误
Chronic pulmonary heart disease complicated with pulmonary edema is a serious clinical disease, the wrong diagnosis often leads to the failure of rescue. In the past 10 years, 286 cases of chronic pulmonary heart disease admitted to hospital in our hospital, 46 cases of pulmonary edema complicated, of which 24 cases were misdiagnosed, the reasons for misdiagnosis is now a preliminary analysis. Clinical data 24 cases of misdiagnosed patients were admitted to the hospital for acute onset of chronic pulmonary heart disease, and in line with the diagnostic criteria set by the National Pulmonary Heart Disease Conference in 1977. 18 males and 6 females, aged 48 to 76 years, mean 57 years. 9 cases of respiratory failure, heart failure in 7 cases, respiratory failure and heart failure in 8 cases. Accompanied by high heart, coronary heart disease and other left ventricular lesions in 7 cases, 17 cases without accompanying disease. Pulmonary edema complicated with clinical manifestations, 8 cases of sitting breathing, episodic dyspnea, cough white or pink foam sputum in 10 cases, asthma-like episodes in 6 cases. Physical examination of lung full of wet rales in 15 cases, lungs covered with wheeze and double lung wet rales in 9 cases. Blood gas analysis PaO_2 <6.65kPa in 11 cases, <7.98kPa in 6 cases,> 7.98kPa in 7 cases; PaO_2> 5.98kPa <7.28kPa in 14 cases,> 7.28kPa <8.64APa in 8 cases and> 8.64kPa in 2 cases. error