肺栓塞和深静脉血栓形成的肺栓塞
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
概括
肺栓塞 (PE) 和深静脉血栓塞 (DVT) 是重要的心血管疾病. 早期诊断和抗凝治疗对于管理静脉血栓栓塞并预防严重后果至关重要.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 肺部病理学 肺部病理学
背景情况:
- 肺栓塞 (PE) 是心血管死亡的首要原因,潜在的后果如慢性血栓栓塞性肺高血压.
- 静脉血栓塞栓症 (VTE) 与动脉血症具有共同的危险因素和病理生理学,涉及炎症,高凝固性和内皮损伤.
- 精确的VTE诊断依赖于临床概率评估,D-二次测试,深静脉血栓症 (DVT) 的压缩超声波和PE的胸部CT.
研究的目的:
- 提供肺栓塞和腿部深静脉血栓的全面概述.
- 讨论静脉血栓栓塞的诊断,风险分层和治疗.
- 突出新兴的抗凝药疗法和预防的不足利用.
主要方法:
- 审查有关静脉血栓栓塞的当前文献和临床指导方针.
- 讨论诊断方式,包括D-二次体测试,超声波和CT.
- 分析治疗策略,包括抗凝血,血栓溶解,栓塞术和药物预防.
主要成果:
- 抗凝药是静脉瘤治疗的基石,大多数患者反应良好.
- 风险分层对于确定PE患者需要先进治疗的必要性至关重要,例如血栓溶解或栓塞切除术.
- 新型口服抗凝剂比传统疗法具有潜在的优势,但预防在高危住院患者中仍未得到充分利用.
结论:
- 有效管理PE和DVT需要及时诊断和适当的抗凝药.
- 风险分层指导肺栓塞的先进治疗决策.
- 需要改善VTE预防的实施和采用新的口服抗凝剂.
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