Grigorakos Leonidas, Sotiriou Evangelia, Myrianthefs P, Michail Anastasia, Koulendi Despina, Zidianakis Vasilis, Gianakopoulos K, Baltopoulos G
Athens University School of Nursing, Intensive Care at Trauma, Hospital of Athens KAT, Kifisia, Athens, Greece.
Hepatogastroenterology. 2008 May-Jun;55(84):887-90.
BACKGROUND/AIMS: Pulmonary embolism (PE) is a potentially life threatening disease. Clinical signs and symptoms allow the clinician to determine the pretest probability of someone having pulmonary embolism but are insufficient to diagnose or rule out the condition. This paper aims to study the clinical presentation, identify the risk factors and evaluate the diagnostic strategies and management of patients with PE.
The medical files of 69 patients were searched, who were diagnosed with PE and who were admitted to the Surgical Care Unit.
Dyspnea, pleuritic pain, haemoptysis, fever and cough were the most common presenting symptoms. Risk factors for PE were found in 90% of cases. D-dimers assay was elevated in all cases (100%) and the other diagnostic strategies used showed great accuracy in confirming the pretest probabilities of PE. It is of high importance that 75% of the patients had deep vein thrombosis as assessed by venous ultrasonography. Mortality due to PE was approximately 6.9%.
PE can be often overlooked with hazardous consequences. Clinical evaluation in combination with spiral CT or lung scintigraphy and vein ultrasound and D-dimer level can establish the diagnosis in the majority of patients so that effective treatment to be started as soon as possible.
背景/目的：肺栓塞（PE）是一种潜在的危及生命的疾病。临床症状和体征可帮助临床医生确定某人患肺栓塞的预测试概率，但不足以诊断或排除该疾病。本文旨在研究肺栓塞患者的临床表现，识别危险因素，并评估其诊断策略及治疗方法。
检索了69例被诊断为肺栓塞且入住外科护理病房患者的病历。
呼吸困难、胸膜炎性疼痛、咯血、发热和咳嗽是最常见的症状。90%的病例发现了肺栓塞的危险因素。所有病例（100%）的D-二聚体检测结果均升高，所采用的其他诊断策略在确认肺栓塞的预测试概率方面显示出很高的准确性。通过静脉超声检查发现，75%的患者患有深静脉血栓形成，这一点非常重要。肺栓塞导致的死亡率约为6.9%。
肺栓塞常常容易被忽视，后果严重。结合螺旋CT或肺闪烁扫描、静脉超声和D-二聚体水平进行临床评估，可在大多数患者中确立诊断，从而尽快开始有效治疗。
