From the Division of Cardiology, Yale University, New Haven, CT (JC); Division of Cardiology, Medical College of Georgia at the Augusta University Medical Center (VA); and the Department of Family Medicine, Medical College of Georgia at the Augusta University Medical Center, Augusta (TW).
J Am Board Fam Med. 2021 Mar-Apr;34(2):402-408. doi: 10.3122/jabfm.2021.02.200308.
Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. In service of providers at the point of contact with acute PE, this review aims to summarize the data pertinent to rapid risk assessment and the interpretation of diagnostics used to that end. The role of PERT and the indications for systemic fibrinolysis and invasive therapies are also discussed.
尽管近年来在急性肺栓塞(PE)的评估、风险分层和治疗方面取得了进展,但它仍是美国每年导致心血管发病率和死亡率的主要原因。患者的表现和预后存在异质性,出现了多种诊断和治疗工具,以帮助为患者提供适当的护理水平和治疗方法的激进程度。幸运的是,现在越来越多的机构拥有肺栓塞反应团队(PERT),可以紧急协助评估和管理大量和亚大量 PE 患者的风险。为了与急性 PE 患者接触的提供者提供服务,本综述旨在总结与快速风险评估以及用于该目的的诊断的相关数据。还讨论了 PERT 的作用以及全身溶栓和介入治疗的适应症。