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目的:从法医病理角度探讨老年人肺动脉栓塞临床特点,为临床准确诊断肺动脉栓塞疾病提供可靠依据,降低误诊、漏诊几率。方法:对7例老年肺动脉栓塞死亡患者临床资料进行回顾性分析,内容包括患者临床表现、临床检查结果等,之后对其进行尸检,记录尸检病理结果,对肺动脉栓塞临床特征进行总结。结果:老年人肺动脉栓塞患者临床表现为突发性胸膜痛、心悸、冷汗、胸闷、咯血、突发劳力性呼吸困难甚至晕厥等,最终因肺部出现急性循环衰竭导致死亡。尸检结果为将老年肺动脉栓塞患者心脏及肺动脉切开后均可见血栓形成,且数量较多或体积较大,血栓可呈现出红色或混合性质。结论:老年人具有肺动脉栓塞多种危险因素,因此肺动脉栓塞疾病发生率较高,易形血栓威胁健康及生命安全,应引起临床医务工作者及法医工作者高度重视。
Objective: To explore the clinical features of pulmonary embolism in the elderly from the perspective of forensic pathology, to provide a reliable basis for clinical diagnosis of pulmonary embolism and to reduce the risk of misdiagnosis and missed diagnosis. Methods: The clinical data of 7 elderly patients with pulmonary thromboembolism were retrospectively analyzed, including the clinical manifestations and clinical examination results. The patients were then autopsy, the autopsy results were recorded, and the clinical features of pulmonary embolism were summarized. Results: The clinical manifestations of pulmonary embolism in elderly patients with sudden pleural pain, palpitations, cold sweat, chest tightness, hemoptysis, sudden exertional dyspnea or even syncope, and ultimately death due to acute pulmonary failure occurred in the lungs. The result of autopsy is that thrombosis can be seen after the heart and pulmonary artery of elderly patients with pulmonary embolism are cut open, and the number is larger or the volume is larger. The thrombus may present red or mixed nature. Conclusion: Elderly people have many risk factors of pulmonary embolism. Therefore, the incidence of pulmonary embolism is high, the thrombus-prone thrombus is a threat to their health and life safety, which should be paid great attention by clinicians and forensic workers.