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目的:探讨如何提高急性肺栓塞(APE)的诊断率和减少误诊率。方法:对1999/2008年间误诊为急性冠脉综合征(ACS)的APE患者临床特点,误诊情况进行分析。结果:26例均有胸闷呼吸困难,胸痛18例;PaO2降低24例;心电图改变主要有窦速22例,T波异常16例,12例行冠脉造影正常,经常规冠心病治疗无效。结论:对于不能解释的呼吸困难,同时合并胸闷气短等症状,伴心率增快的患者应警惕PE。
Objective: To explore how to improve the diagnosis rate and reduce the misdiagnosis rate of acute pulmonary embolism (APE). Methods: The clinical features and misdiagnosis of patients with APE misdiagnosed as acute coronary syndrome (ACS) during 1999-2008 were analyzed. Results: 26 cases had chest tightness, dyspnea, chest pain in 18 cases; PaO2 decreased in 24 cases; electrocardiogram changes mainly in sinus speed in 22 cases, T wave abnormalities in 16 cases, 12 cases underwent coronary angiography, conventional coronary heart disease treatment ineffective. Conclusion: For unexplained dyspnea, combined with chest tightness and shortness of breath and other symptoms, patients with heart rate should be alert to PE.