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为进一步了解肺血栓栓塞 (PTE)的临床特征 ,提高早期诊断率 ,收集 1982年 11月～ 2 0 0 1年 2月尸检诊断PTE 5 0例 ,分析其临床及病理特点。结果显示 ,PTE以老年患者居多 ,基础疾病以心血管疾病及恶性肿瘤最常见 ,其他有肺炎、慢性阻塞性肺疾病、糖尿病、手术和创伤等。临床表现不典型 ,多表现为呼吸困难突然出现或加重、晕厥、猝死和低氧血症等 ,具有典型“三联征”者极少。病理特点为巨大肺栓塞 2 3例 ,次巨大肺栓塞 2 7例 ,其中 13例猝死 ,肺梗死 11例。生前正确诊断 8例。误诊原因为临床医师对PTE的临床特点认识不足、警惕性低。提示应对可疑PTE的病人应尽快行临床可能性评估分析并进一步合理安排各项检查以利诊断与治疗
To further understand the clinical features of pulmonary thromboembolism (PTE) and improve the early diagnosis rate, collect 50 cases of PTE from autopsy from November 1982 to February 2001 and analyze the clinical and pathological features. The results showed that the majority of PTE in elderly patients, the most common underlying diseases with cardiovascular disease and malignant tumors, other pneumonia, chronic obstructive pulmonary disease, diabetes, surgery and trauma. Clinical manifestations of atypical, manifested as sudden or worsening dyspnea, syncope, sudden death and hypoxemia, with the typical “triad” who rarely. Pathological features of great pulmonary embolism in 23 cases, 26 cases of submaxial pulmonary embolism, of which 13 cases of sudden death, pulmonary infarction in 11 cases. Correct diagnosis of eight cases before birth. The reason for misdiagnosis is clinicians lack of understanding of the clinical features of PTE, low vigilance. Prompt response to patients with suspicious PTE should be as soon as possible to assess the clinical possibility and further rationalize the arrangements to facilitate the diagnosis and treatment of the test