肺栓塞や深静脈血栓症による肺栓塞です
Samuel Z Goldhaber1, Henri Bounameaux
1Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Cardiovascular Division, Boston, MA 02115, USA. sgoldhaber@partners.org
Lancet (London, England)
|April 13, 2012
まとめ
肺栓塞 (PE) と深静脈血栓症 (DVT) は,重要な心血管疾患である. 早期診断と抗凝固治療は,静脈血栓塞栓症の管理と重篤な結果の予防に不可欠です.
科学分野:
- 心血管医学 心血管医学
- 血液学 ヘマトロジ
- 肺内科 肺内科 肺内科
背景:
- 肺栓塞症 (PE) は,慢性血栓塞栓性肺高血圧のような潜在的な後遺症を持つ,心血管疾患による死亡の主な原因です.
- 静脈性血栓塞栓症 (VTE) は,炎症,高血栓性,内皮損傷を含むアテロトロンボシスとリスク要因と病理生理学を共有しています.
- VTEの正確な診断は,臨床的確率評価,D-ダイマー検査,深静脈血栓症 (DVT) の圧縮超音波,およびPEの胸部CTに依存しています.
研究 の 目的:
- 肺栓塞症と足の深い静脈栓塞症の包括的な概要を提供するために.
- 静脈血栓塞栓症の診断,リスクの分層化,および治療について議論します.
- 新興の抗凝固剤療法と予防の未充分利用を強調する.
主な方法:
- 静脈血栓塞栓症に関する現在の文献と臨床ガイドラインのレビュー.
- D-ダイマー検査,超音波検査,CT検査を含む診断方法についての議論.
- 抗凝固剤,血栓溶解,栓切除,および薬理学的予防を含む治療戦略の分析.
主要な成果:
- 抗凝固薬はVTE治療の礎石であり,ほとんどの患者は良好な反応を示しています.
- リスクの分層化は,PE患者における血栓溶解または栓切除のような高度な治療法の必要性を決定するために不可欠です.
- 新しい経口抗凝固剤は,従来の治療法に比べて潜在的な利点がありますが,リスクの高い入院患者では,予防法は依然として不足しています.
結論:
- PEとDVTの効果的な管理には,早期の診断と適切な抗凝固薬が必要です.
- リスクの階層化は,肺栓塞の高度な治療決定を導く.
- VTE予防の実施を改善し,新しい経口抗凝固剤の採用は正当化されています.
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