急性肺栓塞诊断与治疗的研究进展

摘要

Acute pulmonary embolism(APE) is one of the diseases with high mortality.The possibility of APE could be determined by Revised Geneva score,and it could be diagnosed by echocardiography,CT angiography,lung scintigraphy and so on.At the same time,the risk stratifications of patients are based on the presence of shock and hypotension,the severity index of pulmonary embolism,echocardiography and cardiac markers.The research on the risk factors of APE,the discovery of new clinical laboratory index,the research of routine assistant examination technology and the development of the new type of auxiliary examination are in continuous progress.The main treatment of APE contains thrombolytic therapy,pulmonary embolectomy,catheter-based treatment,caval filter and anticoagulation theraphy.There are also some reports showing that statin treatment could decrease the risk of recurrent pulmonary embolism.%急性肺栓塞(APE)是临床病死率高的疾病之一,可通过修正的Geneva评分判断临床患病可能性,通过超声心动图、CT血管造影及肺闪烁血管造影术等进行诊断,同时依据休克与低血压的出现与否、肺栓塞严重指数大小、心脏彩色多普勒超声及心脏标志物结果对患者进行危险分层.目前APE危险因素的研究、新型临床化验指标及常规辅助检查技术的研究与新型相关辅助检查的探索仍在不断进展.APE的治疗方式主要包括溶栓、肺动脉切开取栓术、导管治疗、腔静脉滤器置入及抗凝治疗,他汀类药物可降低肺栓塞复发风险.