目的　提高对肺栓塞的认识并探讨误诊原因。　方法　通过临床表现、实验室检查、X线胸片、肺核素显像等方法 ,对 2 8例老年人肺栓塞患者进行回顾性分析 ,并比较了老年肺栓塞与非老年肺栓塞患者在病因学、临床表现及误诊方面的差异。　结果　老年人易发肺栓塞的因素为 :下肢深静脉血栓、恶性肿瘤、外科手术及创伤、卧床 >3d和高血压等 ,老年组肺栓塞的误诊率高于非老年组 ,误诊率高达 6 0 7% ,最易误诊为肺炎 ,其次为心肌梗死。医师的认识不足是造成误诊的主要原因。　结论　肺栓塞在老年人中常见且容易造成误诊 ,应引起临床医师的充分重视。 Objective To improve the understanding of pulmonary embolism and explore the causes of misdiagnosis. Methods The clinical data of 28 elderly patients with pulmonary embolism were retrospectively analyzed by means of clinical manifestations, laboratory tests, X-ray and pulmonary imaging. The causes of pulmonary edema in elderly patients with pulmonary embolism were compared Differences in learning, clinical manifestations and misdiagnosis. Results The most common causes of pulmonary embolism in the elderly were lower extremity deep vein thrombosis, malignant tumor, surgery and trauma, bed rest> 3d and hypertension. The misdiagnosis rate of pulmonary embolism in the elderly group was higher than that in the non-elderly group, and the misdiagnosis rate was 60 7%, most likely to be misdiagnosed as pneumonia, followed by myocardial infarction. Physicians lack of understanding is the main reason for misdiagnosis. Conclusions Pulmonary embolism is common and easy to cause misdiagnosis in the elderly, which should arouse the full attention of clinicians.