以呕吐为唯一首发症状的肺栓塞1例并文献复习

A Case of Pulmonary Embolism with Vomiting as the Only Initial Symptom and Literature Review

摘要: 肺栓塞(Pulmonary embolism, PE)是内源性或外源性栓子堵塞肺动脉或其分支引起肺循环障碍的临床和病理生理综合征，其中最常见的为肺血栓栓塞症(血栓主要来源于深静脉血栓形成)，其急性发病死亡率非常高，引起人们的广泛关注。但PE早期临床表现多种多样，没有特异性，主要表现为呼吸困难、胸痛、咯血，部分患者症状非常不典型甚至无症状，很难对其作出诊断，这将导致误诊率或漏诊率显著增加。然而以呕吐为唯一首发症状的肺栓塞却较为少见，本文旨在提供1例典型病例的患者病历资料，并探讨其诊治过程，加强对本病的认识和提高对肺栓塞的重视，减少临床误诊率及漏诊率。

Abstract: Pulmonary embolism (PE) is a clinical and pathophysiological syndrome in which endogenous or exogenous emboli block the pulmonary artery or its branches and cause pulmonary circulation disorders. Among them, the most common is pulmonary thromboembolism (thrombosis mainly comes from deep vein thrombosis). The acute mortality of PE is very high, which has attracted ex-tensive attention. However, the early clinical manifestations of PE are diverse and non-specific, mainly manifested as dyspnea, chest pain and hemoptysis. Some patients have very atypical or even asymptomatic symptoms, which makes it difficult to make a diagnosis, which will lead to a signifi-cant increase in the rate of misdiagnosis or missed diagnosis. However, pulmonary embolism with vomiting as the only initial symptom is relatively rare. This paper aims to provide the medical rec-ord of a typical case and discuss its diagnosis and treatment process, so as to strengthen the under-standing of this disease and improve the attention to pulmonary embolism, and reduce the rate of clinical misdiagnosis and missed diagnosis.