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肺血栓栓塞症的临床诊治进展

Clinical diagnosis and treatment of pulmonary thromboembolism
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摘要 肺血栓栓塞症(pulmonary thromboembolism,PTE)为肺栓塞最常见的类型,是指来自静脉系统或右心血栓脱落后阻塞肺动脉或其分支所导致的疾病,阻塞范围达到一定程度后致呼吸循环系统障碍引起心肺功能、血流动力学等异常,从而诱发一系列的临床表现。在曾经的临床治疗中,由于诊疗技术的落后及临床医生对肺血栓栓塞症的认识极其微薄,PTE易被误诊、漏诊,尤其易被缺乏临床经验的一线青年医师忽略,一度被认为是罕见病。近年来,大量循证医学证据表明肺血栓栓塞症在我国已成为常见病。肺血栓栓塞症具有高患病率、高复发率、高致残率、高病死率和高疾病经济负担的特点,已成为重大的健康问题,严重威胁公众人群健康的临床急症之一,有报道称肺血栓栓塞症是继冠心病、脑卒中后常见的重要死亡原因。随着诊疗技术的创新发展及临床工作者的不断探究,不论是对诱发肺血栓栓塞症危险因素的认识,或是肺血栓栓塞症临床诊断思维或治疗方案的选择,都显现出现代医务者对肺血栓栓塞症更深层的认知。但目前关于肺血栓栓塞症的诊治仍有一些问题,尤其是中危肺血栓栓塞症患者的治疗上目前未有一个统一的规范化诊治方案。本综述主要概括了肺血栓栓塞症的诊治进展。 Pulmonary thromboembolism(PTE)is the most common type of pulmonary embolism.It refers to a series of clinical manifestations caused by obstruction of pulmonary artery or its branches after the detachment of vein or right heart thrombus.When the obstruction reaches a certain extent,it causes respiratory and circulatory system disorders,such as cardiopulmonary function,hemodynamics and so on.In the past,PTE was easily misdiagnosed and missed due to the backwardness of diagnosis and treatment technology and the poor knowledge of clinicians about PTE,especially neglected by young doctors lacking clinical experience,which was once considered a rare disease.In recent years,a large number of evidence-based medical evidence shows that PTE has become a common disease in China.PTE has the characteristics of high morbidity,high recurrence rate,high disability rate,high mortality rate and high economic burden of disease.It has become a major health problem and one of the clinical emergencies that seriously threaten the health of the public.It has been reported that PTE is a common cause of death following coronary heart disease and stroke.With the innovative development of diagnosis and treatment technology and the continuous exploration of clinical workers,whether it is the un-derstanding of the risk factors of inducing PTE,or the choice of clinical diagnostic thinking or treatment options of PTE,it shows that modern medical practitioners have a deeper understanding of PTE.However,there are still some problems in the diagnosis and treatment of PTE,especially in the treatment of middle-risk PTE patients,there is no unified and stand-ardized diagnosis and treatment program.This review summarizes the progress of diagnosis and treatment of PTE.
作者 陈宗喻 杜娟 张先明 CHEN Zong-yu;DU Juan;ZHANG Xian-ming(School of Clinical Medicine,Guizhou Medical University,Guiyang,Guizhou 550004,China;不详)
出处 《中华全科医学》 2020年第7期1181-1184,共4页 Chinese Journal of General Practice
基金 国家自然科学基金项目(81660018)。
关键词 肺血栓栓塞症 诊断治疗 研究进展 Pulmonary thromboembolism Diagnosis and treatment Recent advance
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