Giordano Nicholas J, Jansson Paul S, Young Michael N, Hagan Kaitlin A, Kabrhel Christopher
Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Boston, MA.
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Department of Emergency Medicine, Harvard Medical School, Boston, MA.
Tech Vasc Interv Radiol. 2017 Sep;20(3):135-140. doi: 10.1053/j.tvir.2017.07.002. Epub 2017 Jul 5.
Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism that can be challenging to diagnose and manage. PE occurs when there is obstruction of the pulmonary vasculature and is a common cause of morbidity and mortality in the United States. A combination of acquired and inherited factors may contribute to the development of this disease and should be considered, since they have implications for both susceptibility to PE and treatment. Patients with suspected PE should be evaluated efficiently to diagnose and administer therapy as soon as possible, but the presentation of PE is variable and nonspecific so diagnosis is challenging. PE can range from small, asymptomatic blood clots to large emboli that can occlude the pulmonary arteries causing sudden cardiovascular collapse and death. Thus, risk stratification is critical to both the prognosis and management of acute PE. In this review, we discuss the epidemiology, risk factors, pathophysiology, and natural history of PE and deep vein thrombosis.
肺栓塞（PE）是一种常见且可能致命的静脉血栓栓塞形式，其诊断和管理具有挑战性。当肺血管系统发生阻塞时就会出现肺栓塞，它是美国发病和死亡的常见原因。获得性因素和遗传性因素共同作用可能导致该病的发生，应予以考虑，因为它们对肺栓塞的易感性和治疗都有影响。疑似肺栓塞的患者应尽快进行有效评估以诊断并给予治疗，但肺栓塞的表现多样且不具特异性，因此诊断具有挑战性。肺栓塞范围可从小的无症状血凝块到可阻塞肺动脉导致突然心血管崩溃和死亡的大栓子。因此，风险分层对于急性肺栓塞的预后和管理至关重要。在本综述中，我们讨论了肺栓塞和深静脉血栓形成的流行病学、危险因素、病理生理学及自然病史。
