Church Amy, Tichauer Matthew
Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA.
Emerg Med Pract. 2012 Dec;14(12):1-22. Epub 2012 Nov 20.
Each year in the United States, up to 900,000 individuals will suffer from acute pulmonary embolism, resulting in an estimated 200,000 to 300,000 hospital admissions. Despite decades of research on the topic, the diagnosis remains elusive in many situations and the fatality rate remains significant. This issue presents a review of the current evidence guiding the emergency medicine approach to the diagnosis and treatment of pulmonary embolism. Key to this approach is the concept of risk stratification: using factors from the history and physical examination, plus ancillary tests, to guide clinical decision making. The pathophysiology of pulmonary embolism and decision-support tools are reviewed, and emergency department management strategies are described.
在美国，每年有多达90万人会患急性肺栓塞，估计导致20万至30万人住院。尽管对该主题进行了数十年的研究，但在许多情况下诊断仍然难以捉摸，死亡率仍然很高。本文综述了目前指导急诊医学诊断和治疗肺栓塞方法的证据。这种方法的关键是风险分层的概念：利用病史和体格检查中的因素，再加上辅助检查，来指导临床决策。本文回顾了肺栓塞的病理生理学和决策支持工具，并描述了急诊科的管理策略。
