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低风险患者是否真的需要在肺栓塞后进行随访?
Lesley Alexander1, Susan Burnie1, Catherine Rossiter1
1Medical and Respiratory Units, Dumfries and Galloway Royal Infirmary, Dumfries, UK.
The journal of the Royal College of Physicians of Edinburgh
|January 8, 2025
概括
肺栓塞 (PE) 患者的低风险得分往往可以作为门诊患者进行管理. 这项研究发现,即使没有严格的随访,也很少出现不良结果,这挑战了目前的指导方针.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 内部医学 内部医学
背景情况:
- 英国胸腔协会的指导方针建议对低风险肺栓塞 (PE) 患者进行门诊 (OP) 管理.
- 这一建议取决于是否有可靠的后续和监测系统.
研究的目的:
- 为了评估低风险PE患者在门诊治疗的结果.
- 评估对PE患者严格的随访途径的必要性.
主要方法:
- 对109名连续的PE患者进行了回顾性队列研究.
- 主要结局包括复发性静脉血栓栓塞,严重出血,1年死亡率和慢性血栓栓塞性肺高血压 (CTEPH).
主要成果:
- 72%的患者具有低风险的肺栓塞严重性指数 (PESI) 分数 (I-II).
- 尽管大多数患者缺乏正式的随访,但不良结果很少发生.
- 在34名接受心声扫描的患者中没有检测到CTEPH.
结论:
- 这些发现质疑在所有肺栓塞病例中对严格的随访途径的普遍要求.
- 在没有密集监测的情况下,对于精选的低风险PE患者,门诊治疗可能是安全的.
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