Iber C, Sirr S
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415.
Semin Respir Infect. 1988 Sep;3(3):203-16.
Pulmonary embolism (PE) is often unrecognized or misdiagnosed because of the lack of specificity of clinical signs and symptoms. PE shares many of the clinical features of pneumonia and is therefore often unrecognized in elderly patients who present with low-grade fever, modest leukocytosis, and pulmonary infiltrates. Assessment of clinical risk factors increases the usefulness of diagnostic tests. The accuracy of diagnosis is improved if specific tests are performed. Ventilation-perfusion lung scans, noninvasive or contrast venography, and pulmonary angiography increase the likelihood of correct diagnosis. Since pulmonary angiography is a relatively low-risk procedure, it should be performed in most patients suspected of having PE who have nondiagnostic lung scans and negative lower extremity venous studies.
肺栓塞（PE）常常未被识别或误诊，因为临床体征和症状缺乏特异性。PE与肺炎有许多共同的临床特征，因此在出现低热、轻度白细胞增多和肺部浸润的老年患者中常常未被识别。评估临床危险因素可提高诊断性检查的效用。如果进行特异性检查，诊断的准确性会提高。通气-灌注肺扫描、无创或造影静脉造影以及肺血管造影可增加正确诊断的可能性。由于肺血管造影是一种相对低风险的检查，对于大多数怀疑患有PE但肺扫描无诊断价值且下肢静脉检查阴性的患者都应进行此项检查。
