肺栓塞风险分层:目前的证据和未来的方向
Jihane Jadi1, Natalie D Sridharan2
1Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA - jadij@upmc.edu.
The Journal of cardiovascular surgery
|February 27, 2026
概括
准确的肺栓塞 (PE) 风险分层对于患者的治疗结果至关重要. 本综述探讨了评估PE严重程度和指导个性化治疗策略的当前和新兴工具.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 肺栓塞 (PE) 具有显著的心血管风险,需要精确的诊断和预后.
- 有效的风险分层指导患者管理,治疗选择和分类.
- 传统的评分系统和动态评估是预测PE结果的关键.
研究的目的:
- 审查目前对肺栓塞的风险评估策略.
- 评估PE的既定和新型预测模型.
- 讨论多式联通PE风险分层和个性化护理的未来方向.
主要方法:
- 审查现有的临床预测规则 (威尔斯,日内瓦,赫斯蒂亚,PESI,sPESI).
- 对住院患者的评分系统,成像和生物标志物的分析.
- 探索多学科的肺栓塞反应小组 (PERT) 和混合模型.
主要成果:
- 预试验概率得分 (威尔斯,日内瓦) 指导诊断测试需求.
- 赫斯蒂亚,PESI和sPESI确定了门诊管理的候选人.
- 先进的工具和PERT支持住院患者的多模式风险分层.
结论:
- 对于PE风险评估,正在出现一种综合各种工具的多式联络方法.
- 在PE管理中的个性化护理从精细的风险分层模型中受益.
- 未来的研究应该专注于提高预测准确性和个性化治疗.
相关概念视频
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
553
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
553
Pulmonary Embolism I: Introduction
1.0K
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
1.0K
Pulmonary Embolism III: Nursing Management
541
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
541
Venous Thrombosis III: Interprofessional Care
423
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
423
Pulmonary Hypertension: Classification and Pathogenesis
721
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
721
Venous Thrombosis IV: Nursing Management
320
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
320


