Skralovnik-Stern A
Plucne Bolesti. 1989 Jan-Jun;41(1-2):107-11.
Assessing the pulmonary embolism we are thrown into two dilemmas: whether due to the overlooked pulmonary emboli the morbidity and mortality may significantly increase or complications are possible due to the unsuitable anticoagulant therapy in false diagnosis. Several clinical symptoms and signs are nonspecific. Ventilatory perfusion scintigraphy is a sensitive test, yet its specificity is varied according to the number and extent of defects. In multiple segmental or lobar perfusion defects at preserved ventilation there is a great possibility of of pulmonary embolism. If only slight defects are involved pulmonary embolism could not be excluded although the ventilation is disturbed in this region. However, pulmonary angiography remains the standard test.
一是由于肺栓塞被漏诊，发病率和死亡率是否会显著增加；二是在误诊情况下，不适当的抗凝治疗是否可能导致并发症。一些临床症状和体征是非特异性的。通气灌注闪烁扫描是一项敏感的检查，但其特异性会因缺损的数量和范围而有所不同。在通气正常但存在多个节段或肺叶灌注缺损时，肺栓塞的可能性很大。如果仅涉及轻微缺损，尽管该区域通气受到干扰，也不能排除肺栓塞。然而，肺血管造影仍然是标准的检查方法。
