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肺栓塞后综合征:根据修订的AWMF-S2k指南进行更新
F Joachim Meyer1, Christian Opitz2
1Lungenzentrum München (Bogenhausen-Harlaching) - München Klinik gGmbH, Sanatoriumsplatz 2 München, München, Bavaria, Germany.
Hamostaseologie
|March 26, 2024
概括
急性肺栓塞 (PE) 的幸存者可能会患上后PE综合征 (PPES),其特征是持续性呼吸不良. 结构化的随访对于检测慢性血栓栓塞性肺病 (CTEPD) 或高血压 (CTEPH) 及时干预至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 血管医学 血管医学
背景情况:
- 肺栓塞后 (PE) 综合征 (PPES) 可以表现为持续性呼吸障碍在炼尽管抗凝.
- PPES可能表明潜在的慢性血栓栓塞性肺病 (CTEPD) 或慢性血栓塞性肺高血压 (CTEPH).
- 无论是CTEPD还是CTEPH,都涉及影响肺动脉和动脉小动脉的双重血管病变.
研究的目的:
- 为EP幸存者概述一个结构化的后续算法.
- 为了确定患有CTEPH风险的患者.
- 为指导CTEPH的诊断和治疗途径.
主要方法:
- 最初的评估包括确定CTEPH的临床症状和危险因素.
- 一个逐步的诊断方法包括心声学,通风 perfusion 扫描,NT-proBNP 水平,心肺运动测试,和肺动脉导管通过血管学.
- 管理需要在经验丰富的中心采取多学科的方法.
主要成果:
- 一个结构化的后续算法有助于在PE幸存者中检测CTEPH.
- 早期发现CTEPH可以及时进行干预.
- 全面的诊断工作对于准确的诊断至关重要.
结论:
- 对于急性PE的幸存者来说,有结构的后续对确定CTEPH至关重要.
- 早期诊断和专门中心的治疗改善了CTEPH患者的治疗结果.
- 对于CTEPH的治疗选择包括肺内关节切除术,气球肺血管整形术和药理干预.
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