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引用次数: 0
摘要
近年来,肺动脉栓塞(PE)的诊断越来越重要,但只有约 15-25% 的疑似病例能得到确诊。尽管技术在不断进步,但由于辐射和造影剂的暴露,放射学方法仍然存在问题。临床评分在 PE 风险评估中起着至关重要的作用。高危情况需要采取特殊措施,而阴性 D-二聚体则有助于避免过度诊断。计算机断层扫描肺血管造影术(CTPA)仍是具有高敏感性和特异性的黄金标准。治疗需要一个跨学科团队(肺栓塞应对团队,PERT)。病情稳定的患者可选择抗凝治疗,病情不稳定或治疗不成功的患者可考虑溶栓或介入治疗。两种治疗方式都需要考虑副作用,尤其是出血风险。
[Diagnostics and treatment of pulmonary artery embolisms].
In recent years the diagnostics of pulmonary artery embolisms (PE) has gained significance, with confirmation occurring in only about 15-25 % of suspected cases. Despite technological advances, radiological methods remain problematic due to radiation and contrast medium exposure. Clinical scores play a crucial role in the risk assessment of PE. High-risk situations call for specific measures, while negative D‑dimers can help avoid overdiagnosis. Computed tomographic pulmonary angiography (CTPA) remains the gold standard with high sensitivity and specificity. Treatment requires an interdisciplinary team (pulmonary embolism response team, PERT). Anticoagulation is an option for stable patients, while in unstable or unsuccessful courses, thrombolysis or interventional procedures can be considered. Side effects, especially the risk of bleeding, need to be considered for both forms of treatment.