Huisman M V, Büller H R, ten Cate J W, van Royen E A, Vreeken J, Kersten M J, Bakx B
Center for Thrombosis, Hemostasis and Atherosclerosis Research, Academic Medical Center, Amsterdam, The Netherlands.
Chest. 1989 Mar;95(3):498-502. doi: 10.1378/chest.95.3.498.
In patients presenting with clinically suspected deep vein thrombosis, symptomatic pulmonary embolism is rarely apparent. To assess the prevalence of silent pulmonary embolism in outpatients with proven deep vein thrombosis but without symptoms of pulmonary embolism, perfusion ventilation lung scans were performed in 101 consecutive patients at presentation. Fifty-one percent of these patients had a high probability lung scan at the initiation of treatment. In comparison, in patients referred with suspected venous thrombosis, but who on subsequent objective testing did not have venous thrombosis (n = 44), the prevalence of a high probability-scan for pulmonary embolus was only 5 percent. At repeat lung scanning, performed after one week of anticoagulant treatment, complete to partial improvement was observed in 68 percent of the patients with initially abnormal scans. Lung-scan detected asymptomatic pulmonary embolism occurs frequently in patients presenting with symptomatic deep venous thrombosis, and the majority of these emboli showed significant to complete resolution within one week of anticoagulant treatment.
在临床怀疑有深静脉血栓形成的患者中，有症状的肺栓塞很少见。为评估已证实有深静脉血栓形成但无肺栓塞症状的门诊患者中无症状肺栓塞的发生率，对101例连续就诊的患者进行了灌注通气肺扫描。这些患者中有51%在开始治疗时肺扫描高度可疑。相比之下，在因疑似静脉血栓形成而转诊但随后客观检查未发现静脉血栓形成的患者（n = 44）中，肺栓塞高度可疑扫描的发生率仅为5%。在抗凝治疗一周后进行的重复肺扫描中，最初扫描异常的患者中有68%观察到完全至部分改善。肺扫描检测到的无症状肺栓塞在有症状的深静脉血栓形成患者中很常见，并且这些栓子中的大多数在抗凝治疗一周内显示出显著至完全消退。
