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(王建安)
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内科学新进展 第二章 呼吸系统疾病
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第一节 肺血栓栓塞症(PTE)的诊断和治疗进展
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摘 要 肺血栓栓塞症(PTE)的发病率、病死率高,误诊、漏诊率高。本章综述了肺血栓栓塞症的危险因素,诊断方法,包括通气/灌注扫描(ventilation-perfusion scanning, V/Q)、CT肺动脉造影(CT arteriography, CTPA)、磁共振肺动脉造影(magnetic resonance pulmonary angiography, MRPA)、肺动脉造影(pulmonary arteriography, PAG)和诊断思路。同时探讨肺血栓栓塞症的内科学治疗,主要包括溶栓和抗凝治疗。其中,抗凝为肺血栓栓塞症患者所必需,而溶栓适用于大块和次大块肺栓塞。
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Abstract Pulmonary thromboembolism(PTE)has high morbidity, case fatality as well as high rate of misdiagnosis. The state of risk factors, the art of diagnostic evaluation and treatment of PET was reviewed. Recent advances in imaging and pharmacotherapeutics have tremendously improved the diagnosis and treatment of pulmonary thromboembolism. Nuclear lung scan(V/Q scan), CT pulmonary angiography(CTPA), magnetic resonance pulmonary angiography(MRPA)and pulmonary arteriography(PAG)have revolutionized the diagnostic methodology and risk assessment criteria. While all patients of pulmonary embolism require anticoagulation, systemic thrombolytic therapy is the mainstay of initial treatment in massive and submassive pulmonary embolism.
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一、基本概念
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