肺栓塞的诊断和治疗进展

Diagnosis and Treatment Progress of Pulmonary Embolism

肺栓塞常用的无创诊断手段包括心电图、胸部X线、D-二聚体定量、血气分析、心脏超声、CT肺血管成像及核素肺通气灌注扫描等。有创检查主要是肺血管造影。CT肺血管成像已经逐步被认为是取代肺血管造影的无创检查之首选。肺栓塞的主要治疗包括病因干预、抗栓治疗、体外循环下肺动脉血栓内膜切除术及并发症对症支持等治疗。对急性大面积血栓患者,溶栓治疗疗效优于单纯抗凝,抗凝治疗是肺栓塞的基础治疗。

With a high incidence of pulmonary embolism high misdiagnosis rate and high mortality characteristics.The embolus comes mainly from lower extremity deep venous thrombosis is a disease of two phases.A variety of clinical manifestations of the disease more with pulmonary hypertension caused by hypoxia and hemodynamic instability are closely linked.Commonly used non-invasive diagnostic tools including electrocardiogram,chest X ray,D-dimer quantitative,blood gas analysis,echocardiography,CTPA,MRA and radionuclide lung ventilation perfusion scan.There invasive examination is mainly pulmonary angiography.CTPA in pulmonary trunk,leaves,Duan level of diagnostic sensitivity of pulmonary angiography in non-invasive examination of choice,The main cause of PE treatment,including intervention,antithrombotic therapy,pulmonary thromboendarterectomy under cardiopulmonary bypass surgery and complications of symptomatic support therapy.Large area of acute thrombosis,thrombolytic therapy is superior to simple coagulation,anticoagulation treatment is the basis for pulmonary embolism treatment certificate.PE is now on the diagnosis and treatment progress in recent years is summarized below.