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拨开中度风险（亚大面积）肺栓塞的迷雾：全剂量、低剂量还是不进行溶栓治疗？

Lifting the fog in intermediate-risk (submassive) PE: full dose, low dose, or no thrombolysis?

作者信息

Bhamani Amyn, Pepke-Zaba Joanna, Sheares Karen

机构信息

Department of Respiratory Medicine, Basildon and Thurrock University Hospital, Basildon, Essex, SS16 5NL.

Pulmonary Vascular Diseases Unit, Royal Papworth Hospital, Cambridge, CB23 3RE.

出版信息

F1000Res. 2019 Mar 25;8. doi: 10.12688/f1000research.17861.1. eCollection 2019.

DOI:10.12688/f1000research.17861.1
PMID:30984375
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6436190/
Abstract

Acute pulmonary embolism (PE) is a disease frequently encountered in clinical practice. While the management of haemodynamically stable, low risk patients with acute PE is well established, managing intermediate disease often presents a therapeutic dilemma. In this review, we discuss the various therapeutic options available in this patient group. This includes thrombolysis, surgical embolectomy and catheter directed techniques. We have also explored the role of specialist PE response teams in the management of such patients. ​.

摘要

急性肺栓塞（PE）是临床实践中常见的疾病。虽然血流动力学稳定的急性PE低风险患者的管理方法已得到充分确立，但对中度风险疾病的管理常常带来治疗困境。在本综述中，我们讨论了该患者群体可用的各种治疗选择。这包括溶栓、外科血栓切除术和导管定向技术。我们还探讨了专业PE应对团队在这类患者管理中的作用。

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本文引用的文献

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A Prospective, Single-Arm, Multicenter Trial of Catheter-Directed Mechanical Thrombectomy for Intermediate-Risk Acute Pulmonary Embolism: The FLARE Study.前瞻性、单臂、多中心导管直接机械血栓切除术治疗中危急性肺栓塞：FLARE 研究。
JACC Cardiovasc Interv. 2019 May 13;12(9):859-869. doi: 10.1016/j.jcin.2018.12.022.
2
The implementation of a pulmonary embolism response team in the management of intermediate- or high-risk pulmonary embolism.肺栓塞反应团队在中高危肺栓塞管理中的实施。
J Vasc Surg Venous Lymphat Disord. 2019 Jul;7(4):493-500. doi: 10.1016/j.jvsv.2018.11.014. Epub 2019 Mar 29.
3
Ultrasound-assisted catheter-directed thrombolysis compared with anticoagulation alone for treatment of intermediate-risk pulmonary embolism.超声辅助导管直接溶栓与单纯抗凝治疗中度风险肺栓塞的比较
Pulm Circ. 2018 Oct-Dec;8(4):2045894018800265. doi: 10.1177/2045894018800265. Epub 2018 Aug 24.
4
A five-year, single-centre experience on ultrasound-assisted, catheter-directed thrombolysis in patients with pulmonary embolism at high risk and intermediate to high risk.一项为期五年、单中心的研究，评估在高危和中高危肺栓塞患者中进行超声辅助、导管引导的溶栓治疗的经验。
EuroIntervention. 2018 Nov 20;14(10):1136-1143. doi: 10.4244/EIJ-D-18-00371.
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A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Risk Pulmonary Embolism: The OPTALYSE PE Trial.急性中危肺栓塞患者声脉冲溶栓治疗时间最优随机试验：OPTALYSE PE 试验。
JACC Cardiovasc Interv. 2018 Jul 23;11(14):1401-1410. doi: 10.1016/j.jcin.2018.04.008.
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Outcomes after surgical pulmonary embolectomy for acute submassive and massive pulmonary embolism: A single-center experience.外科肺血栓切除术治疗急性亚大块和大块肺栓塞的结果：单中心经验。
J Thorac Cardiovasc Surg. 2018 Mar;155(3):1095-1106.e2. doi: 10.1016/j.jtcvs.2017.10.139. Epub 2017 Dec 6.
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Thorax. 2018 May;73(5):464-471. doi: 10.1136/thoraxjnl-2017-210040. Epub 2017 Nov 13.
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