肺栓塞的诊断新进展

Pulmonary Embolism New Development of Diagnostic

肺栓塞具有高发病率、高误诊率和高病死率的特点。常用的无创诊断手段包括Ge-neva量表和Wells量表评分、心电图、X线胸片、D-二聚体定量、血气分析、心脏超声、CT肺血管造影、核磁血管成像及核素肺通气/灌注成像等。有创检查主要是肺血管造影。CT肺血管造影在肺动脉主干、叶、段水平的肺栓塞诊断敏感度为96%,特异度为92%,已经逐步被认为是取代肺血管造影无创检查的首选。

Pulmonary embolism has the high rate of attack,errorneous diagnosis and death. Mostly used diagnosis without cut is mainly Geneva score,Wells score,electrocardiogram（ ECG） ,chest X-ray, D-dimer concentration blood gas analysis,heart-echocardiograph,computed tomographic pulmonary angiography（ CTPA） ,magnetic resonance angiography（ MRA） ,pulmonary perfusion/ventilation imaaging and so on. Examination with cut is mainy pulmonary angiography. The accurary in CTPA on pulmonary embolism of different parts（ including the main pulmonary artery,pulmonary lobe and segmentectory） is 96% ,and the idiosyncrasy is 92% . CTPA is gradually accepted as the most effective no-cut diagnosis, which has replaced pulmonary angiography.