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肺栓塞的特殊考虑:游走性血栓和偶发性肺栓塞。

Special Considerations in Pulmonary Embolism: Clot-in-Transit and Incidental Pulmonary Embolism.

机构信息

Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 3B, Boston, MA 02114, USA.

Division of Hematology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

出版信息

Crit Care Clin. 2020 Jul;36(3):531-546. doi: 10.1016/j.ccc.2020.02.008. Epub 2020 May 7.

Abstract

This article describes 2 relatively rare, but complex situations in pulmonary embolism (PE): clot-in-transit (CIT), incidental PE (IPE). CIT describes a venous thromboembolism that has become lodged in the right heart. CIT is associated with high mortality and presents unique challenges in management. Incidental PE (IPE) describes PE diagnosed on imaging performed for another indication. The treatment is complex because there is often a disconnect between the PE severity on imaging and lack of severity of the clinical presentation. We summarize the available literature and aid clinicians as they manage patients with PE across the clinical severity spectrum.

摘要

本文描述了肺栓塞(PE)中两种相对罕见但复杂的情况:游走性血栓(CIT)和偶发性 PE(IPE)。CIT 描述的是一种已经在右心内形成的静脉血栓栓塞症。CIT 与高死亡率相关,并在管理方面带来独特的挑战。偶发性 PE(IPE)描述的是在因其他指征进行的影像学检查中诊断出的 PE。治疗较为复杂,因为影像学上的 PE 严重程度与临床表现的严重程度之间往往存在脱节。我们总结了现有文献,为临床医生管理不同临床严重程度的 PE 患者提供帮助。

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