怀疑肺栓塞患者的诊断策略:一个前性的多中心结局研究
Dominique Musset1, Florence Parent, Guy Meyer
1Service de Radiologie, Hôpital Universitaire Antoine Béclère, Clamart, France.
Lancet (London, England)
|December 21, 2002
概括
暂停抗凝剂治疗对于怀疑肺栓塞 (PE) 的患者来说是安全的,如果他们具有低或中等的临床概率和CT扫描和超声波的负结果. 这种诊断策略确保了随访期间的患者安全.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 心血管医学 心血管医学
- 放射学 放射学是一门学科.
背景情况:
- 未来的多中心结局研究,评估疑似肺栓塞 (PE) 的诊断策略.
- 该策略结合了临床概率评估,螺旋CT和静脉压缩超声波.
- 主要目标:评估低/中等概率PE患者中保留抗凝药的安全性.
研究的目的:
- 评估肺栓塞 (PE) 的诊断策略的安全性和有效性.
- 为了确定抗凝剂治疗是否可以在特定的患者群体中安全地停止.
- 为了减少不必要的抗凝血和相关风险.
主要方法:
- 招募了1041名怀疑PE的住院和门诊患者.
- 低/中等临床概率和阴性螺旋CT/超声波的患者没有接受治疗.
- 高概率患者接受了肺部扫描和/或肺血管造影;所有患者被跟踪了3个月.
主要成果:
- 肺栓塞 (PE) 在34.6%的患者中被诊断为肺栓塞;55人尽管有负的CT,但有阳性超声波.
- 在601名负影像和低/中等概率的患者中,507人没有接受治疗.
- 在随访期间,九名未接受治疗的患者 (1.8%) 经历了静脉血栓栓塞.
结论:
- 暂停抗凝药治疗对于具有PE临床概率低或中等且螺旋CT和超声波检测结果为负的患者是安全的.
- 诊断策略有效地识别出可以安全地放弃抗凝药的患者.
- 这种方法尽量减少治疗风险,同时保持PE的诊断准确性.
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