临床决策规则与 D-二聚体在静脉血栓栓塞症中的应用：当前的争议与未来研究重点。
Clinical decision rules and D-Dimer in venous thromboembolism: current controversies and future research priorities.
机构信息
Hematology, University of Ottawa and The Ottawa Hospital, Ottawa, ON Canada; Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON Canada; Obstetrics and Gynaecology, University of Ottawa and The Ottawa Hospital, Ottawa, ON Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada.
Hematology, University of Ottawa and The Ottawa Hospital, Ottawa, ON Canada; Obstetrics and Gynaecology, University of Ottawa and The Ottawa Hospital, Ottawa, ON Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada.
出版信息
Thromb Res. 2014 Oct;134(4):763-8. doi: 10.1016/j.thromres.2014.07.031. Epub 2014 Aug 4.
Venous thromboembolism (VTE) is a potentially lethal clinical condition that is suspected in patients with common clinical complaints, in many and varied, clinical care settings. Once VTE is diagnosed, optimal therapeutic management (thrombolysis, IVC filters, type and duration of anticoagulants) and ideal therapeutic management settings (outpatient, critical care) are also controversial. Clinical prediction tools, including clinical decision rules and D-Dimer, have been developed, and some validated, to assist clinical decision making along the diagnostic and therapeutic management paths for VTE. Despite these developments, practice variation is high and there remain many controversies in the use of the clinical prediction tools. In this narrative review, we highlight challenges and controversies in VTE diagnostic and therapeutic management with a focus on clinical decision rules and D-Dimer.
静脉血栓栓塞症（VTE）是一种具有潜在致命性的临床病症，在许多不同的临床护理环境中，常见的临床症状会使患者出现 VTE 疑似症状。一旦确诊 VTE，其最佳治疗管理（溶栓、IVC 滤器、抗凝剂类型和持续时间）和理想治疗管理环境（门诊、重症监护）也存在争议。目前已经开发出了一些临床预测工具，包括临床决策规则和 D-二聚体，以协助 VTE 的诊断和治疗管理路径中的临床决策。尽管有这些进展，但实践中的差异仍然很大，在临床预测工具的使用方面仍存在许多争议。在这篇叙述性综述中，我们重点介绍了 VTE 诊断和治疗管理方面的挑战和争议，包括临床决策规则和 D-二聚体。
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