有出血风险的高危肺血栓栓塞症患者可以选择低剂量抗凝吗

Is low-dose anticoagulation a therapeutic option for patients at high risk of bleeding with high-risk pulmonary thromboembolism

本期病例报告栏目报道了1篇有趣的个案,描述了1例术中出现的高危肺血栓栓塞症(PTE)患者识别、救治与后期处理的过程。该患者最初确实属于高危PTE,但在临床处理过程中其危险分层变化为了中高危,我们应该动态评估其危险分层,根据患者的病情变化制定诊疗方案;同时患者合并有高出血风险,对此我们应该尽量规避出血风险,充分考虑当时、当地可应用的条件,制定安全有效的治疗方案;患者所处的社会经济条件可能会影响到最终诊疗方案的实施,我们需要与患方进行充分沟通,尽可能考虑全面,做好预案,最大程度地保障患者的生命安全。

This issue of Chinese Journal of Tuberculosis and Respiratory Diseases published an interesting case illustrating the identification,treatment,and post-treatment management of a high-risk pulmonary thromboembolism(PTE)that occurred during surgery.It was a high-risk case of PTE,but during treatment,the risk stratification changed to medium-high risk.We should dynamically assess risk stratification and develop diagnosis and treatment plans based on changes in the patient′s condition.At the same time,there was a high risk of bleeding in this patient.We should try to decrease the risk of bleeding as much as possible,consider all the conditions that can be applied at that time and on a local level,and devise a safe and effective treatment plan.The socio-economic status of patients may have an impact on how the final diagnosis and treatment plan are implemented.We need to communicate fully with patients,consider comprehensively,and prepare contingency plans to ensure patients′life safety to the greatest extent possible.