目的　探讨急性肺栓塞 (PE)及时准确的早期诊断和治疗经验。方法　对 15例肺栓塞病人的临床资料进行分析。结果　血气分析、D 二聚体是肺栓塞的初步筛选手段 ,D 二聚体 >5 0 0 μg/L为 73 3% ,氧合指数 <30 0 ,阳性率 80 % ,放射性核素显像 (ECT)V/Q阳性率达 10 0 % ,CT增强扫描阳性率 81 8% ,肺动脉造影阳性率 10 0 %。通过重组组织型纤溶酶原激活剂 (rt PA)或尿激酶 (UK)溶栓 ,速避凝及华法令抗凝 ,14例显效 ,1例死亡。结论　以不明原因呼吸困难者需检查ECT或肺动脉造影排除PE ,PE予UK及速避凝、华法令序贯治疗能取得良好治疗效果。 Objective To investigate the timely and accurate early diagnosis and treatment of acute pulmonary embolism (PE). Methods The clinical data of 15 patients with pulmonary embolism were analyzed. Results Blood gas analysis showed that D-dimer was the primary screening method for pulmonary embolism. D-dimer> 500 μg / L was 73 3%, oxygenation index was <30 0, the positive rate was 80%. Radionuclide imaging The positive rate of ECV V / Q was 100%, the positive rate of CT enhanced scan was 81.8%, and the positive rate of pulmonary angiography was 100%. Fourteen cases were markedly effective and one case died of thrombolysis by immediate thrombolysis, immediate contraception, and warfarin through recombinant tissue plasminogen activator (rtPA) or urokinase (UK). Conclusions Patients with dyspnea who have difficulty in breathing need to check ECT or pulmonary arteriography to rule out PE, PE to UK and rapid avoidance and warfarin, and sequential treatment with warfarin can achieve good therapeutic effect.