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急诊科肺栓塞管理面临的挑战与变革。

Challenges and Changes to the Management of Pulmonary Embolism in the Emergency Department.

机构信息

Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 273, New Haven, CT 06519, USA.

Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 273, New Haven, CT 06519, USA.

出版信息

Clin Chest Med. 2018 Sep;39(3):539-547. doi: 10.1016/j.ccm.2018.04.009.

Abstract

The diagnosis and treatment of pulmonary embolism (PE) remains one of the great challenges of emergency medicine. The symptoms of PE are myriad, common, and nonspecific. Undertesting risks missing a potentially life-threatening illness, whereas overtesting adds cost, false-positive diagnoses, incidental findings, and potential adverse impacts from contrast and radiation. Once diagnosed, the severity of PE can range from truly insignificant to deadly, and treatment must be tailored appropriately to the situation. This review discusses basic tenets of emergency department diagnosis and management while highlighting current challenges and recent changes to PE treatment.

摘要

肺栓塞(PE)的诊断和治疗仍然是急诊医学的重大挑战之一。PE 的症状繁多、常见且无特异性。如果检测不足,可能会漏诊潜在的危及生命的疾病,而过度检测则会增加成本、假阳性诊断、偶然发现以及造影剂和辐射带来的潜在不良反应。一旦确诊,PE 的严重程度可能从真正无足轻重到致命不等,治疗必须根据具体情况进行适当调整。本综述讨论了急诊科诊断和管理的基本原则,同时强调了 PE 治疗的当前挑战和最新变化。

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