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[欧洲心脏病学会关于肺栓塞管理的指南]

[European Society of Cardiology guidelines on the management of pulmonary embolism].

作者信息

Melissopoulou M, Ancion A, Lancellotti P

出版信息

Rev Med Liege. 2014 Nov;69(11):594-9.

Abstract

In recent years, several studies and new molecules have emerged in the field of pulmonary embolism. Initial patient management requires rapid assessment of clinical condition. In case of shock, a primary reperfusion approach is requi- red (i.e., pharmacological, surgical or percutaneous). In the other cases, the assessment of the risk of early mortality is needed and treatment with anticoagulant should be started. Very low risk patients can be discharged early. High-intermediate risk patients can sometimes benefit from a reperfusion approach. Individual risk stratification can be refined by the assessment of right ventricular function and biomarkers (troponin, B-type natriuretic peptide). The new anticoagulants can be used in this indication. For most patients, the duration of treatment is 3 months. In this article, we summarize the 2014 recommendations of the European Society of Cardiology for the management of pulmonary embolism.

摘要

近年来,肺栓塞领域出现了多项研究和新分子。对患者的初始管理需要快速评估临床状况。若出现休克,需要采取主要的再灌注方法(即药物、手术或经皮介入)。在其他情况下,则需要评估早期死亡风险并开始抗凝治疗。极低风险患者可早期出院。中高风险患者有时可从再灌注方法中获益。通过评估右心室功能和生物标志物(肌钙蛋白、B型利钠肽)可优化个体风险分层。新型抗凝剂可用于此适应症。对大多数患者而言,治疗持续时间为3个月。在本文中,我们总结了欧洲心脏病学会2014年关于肺栓塞管理的建议。

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