Lavorini Federico, Di Bello Vitantonio, De Rimini Maria Luisa, Lucignani Giovanni, Marconi Letizia, Palareti Gualtiero, Pesavento Raffaele, Prisco Domenico, Santini Massimo, Sverzellati Nicola, Palla Antonio, Pistolesi Massimo
Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, Florence 50134, Italy.
Multidiscip Respir Med. 2013 Dec 19;8(1):75. doi: 10.1186/2049-6958-8-75.
The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature.
急诊科就诊患者或住院患者常被考虑诊断为肺栓塞(PE)。尽管早期治疗非常有效,但PE仍诊断不足,因此,该疾病仍然是一个主要的健康问题。由于症状和体征不具特异性,且抗凝治疗的后果相当严重,因此用于确立或排除诊断的客观检查已成为标准治疗手段。诊断策略应基于对PE可能性的临床评估。当诊断试验结果与临床评估一致时,PE诊断试验的准确性较高。当试验结果与临床可能性不一致时,则需要进行额外检查。本综述文章代表了肺病研究跨学科协会(AIMAR)多学科工作组关于PE诊断和治疗的基于共识的建议。本综述的目的是利用文献证据为临床医生提供一种实用的诊断和治疗管理方法。