急性肺栓塞后处理的实用指南。

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Raza Alikhan, Luke S Howard, Martin Johnson, Shruti Sweeney, David G Kiely, Joanna Pepke-Zaba
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引用次数: 0

摘要

急性肺栓塞(PE)后的随访对于评估恢复情况、考虑持续抗凝治疗的需要和识别慢性血栓栓塞性肺动脉高压(CTEPH)是很重要的,慢性血栓栓塞性肺动脉高压是PE的一种罕见但严重的并发症。由四名肺科医生和一名对PE和/或CTEPH感兴趣的血液科医生组成的指导委员会确定了急性PE随访中的16个困境。回顾了目前的文献,并在专家共识的基础上提出了一种实用的方法。讨论的难题包括:(1)如何处理喘不过气来的病人;(2)疑似CTEPH怎么办;(3) CTEPH与pe后综合征的差异,(4)血栓形成的检测,(5)癌症的检查,(6)抗凝时间和剂量,(7)抗凝治疗的讨论和决策方法,(8)阿司匹林的使用以及抗凝期间是否应停止抗血小板治疗,(9)患者3个月出院时的建议和一级亲属的信息。考虑到可能需要评估的并发症的发生,对术后患者的随访应该是系统的,并考虑患者的个体需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Practical guide to management after an acute pulmonary embolism.

Follow-up after acute pulmonary embolism (PE) is important to assess recovery, consider the need for on-going anticoagulation and identify chronic thromboembolic pulmonary hypertension (CTEPH), a rare but serious complication of PE. 16 dilemmas in the follow-up of acute PE were identified by a steering committee of four pulmonologists and a haematologist with interest in PE and/or CTEPH. Current literature was reviewed and a practical approach suggested based on expert consensus. Dilemmas discussed included: (1) how to manage a breathless patient; (2) what to do if CTEPH is suspected; (3) the difference between CTEPH and post-PE syndrome, (4) testing for thrombophilia, (5) when to investigate for cancer, (6) anticoagulation duration and dose, (7) approaches to discussions and decision-making with respect to anticoagulation, (8) use of aspirin and whether antiplatelet therapy should be stopped during anticoagulation and (9) advice for patients on discharge from hospital at 3 months and information for first-degree relatives. Given the occurrence of complications that may require assessment, follow-up of patients post-PE should be systematic and consider the individual needs of the patient.

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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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