Pforte A
Medizinische Klinik I, Bereich Pneumologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Eur J Med Res. 2004 Apr 30;9(4):171-9.
Pulmonary embolism is a frequently observed clinical symptom. Its mortality rate is ca. 10 % und occurs mainly in the acute phasis. Immobilization, surgery, old age, malignancies, hormonal factors as well as inherited or acquired thrombophilia are important risk factors. Spiral computed tomography and ventilation-perfusion-scintigraphy are the decisive imaging methods. Pulmonary angiography is still the gold standard. The risk of pulmonary embolism could be lowered by 50 % through prophylaxis with unfractioned or low-molecular-weight heparin. The therapy of pulmonary embolism stratifies the clinical grade and reaches from ambulant therapy with low-molecular-weight heparin to thrombolysis or embolectomy in massive pulmonary embolism. Long-term anticoagulation, usually with vitamin-K-antagonists, should be applied according to the individual risk profile of the patient.
肺栓塞是一种常见的临床症状。其死亡率约为10%，主要发生在急性期。制动、手术、老年、恶性肿瘤、激素因素以及遗传性或获得性血栓形成倾向是重要的危险因素。螺旋计算机断层扫描和通气-灌注闪烁扫描是决定性的成像方法。肺血管造影仍是金标准。通过使用普通肝素或低分子肝素进行预防，可将肺栓塞风险降低50%。肺栓塞的治疗根据临床分级进行，从使用低分子肝素的门诊治疗到大面积肺栓塞时的溶栓或栓子切除术。通常使用维生素K拮抗剂进行长期抗凝治疗，应根据患者的个体风险状况应用。
