慢性血栓栓塞性疾病的诊断和管理的最新情况
Alisha Kabadi1, Kim Kerr, Timothy M Fernandes
1Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, California, USA.
Current opinion in pulmonary medicine
|July 18, 2023
概括
慢性血栓栓塞性疾病 (CTED) 的管理是个性化的. 建议及早转诊专科中心,以确定最佳的治疗方法,无论是警等待,气球肺血管造形术 (BPA) 或肺血栓内切除术.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 血管外科 血管外科
背景情况:
- 慢性血栓栓塞性疾病 (CTED) 与慢性血栓塞性肺高血压 (CTEPH) 是不同的.
- CTED的特点是,在肺栓塞后,有残留 perfusion 缺陷,但没有静止性肺高血压的运动性呼吸障碍.
研究的目的:
- 审查CTED的临床特征和诊断标准.
- 总结目前和潜在的CTED治疗选择.
主要方法:
- 审查关于CTED诊断和管理的现有文献.
- 对CTED患者的肺血栓内膜切除术和气球肺血管造形术 (BPA) 的现有研究进行分析.
- 评估目前缺乏关于CTED保守管理策略的数据.
主要成果:
- 肺血栓内膜切除术和BPA在精选的CTED患者中显示为安全有效的治疗方法.
- 在CTED中,保守治疗和侵入性治疗的长期结果在很大程度上仍未报告.
- 与侵入性手术相比,保守管理 (观察,肺高血压向治疗,康复) 的有效性尚不清楚.
结论:
- 基于患者的症状和运动能力,CTED管理是个性化的.
- 早期转诊到专门的CTEPH中心对于最佳的CTED管理至关重要.
- 需要进一步的研究来确定长期的结果,并比较CTED的治疗方式.
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