Kryda M J, Weir G J
Postgrad Med. 1986 May 1;79(6):138-40, 143-8. doi: 10.1080/00325481.1986.11699387.
Pulmonary embolism and venous thrombosis are ubiquitous diseases with significant morbidity and mortality and for which successful although risky treatments are available. Accurate diagnosis is therefore necessary and requires testing beyond the physical examination and history. The number of tests proposed over the years compared with the number in current use attests to the problems with the methods. The more definitive tests are also more invasive, riskier, and more expensive. Individual experience in performance and interpretation of the available tests is of great importance in achieving accurate results, and thus the best scheme for investigation of the patient varies from institution to institution. The most accepted and practiced scheme would involve contrast venography as the initial and final test for suspected venous thrombosis, and pulmonary perfusion imaging (with use of chest radiography in all instances and ventilation imaging in most instances) as the screening test for pulmonary embolism, followed by pulmonary angiography when the scan is not definitive or the clinical picture is divergent from the scan results.
肺栓塞和静脉血栓形成是常见疾病，具有较高的发病率和死亡率，虽然有风险，但有成功的治疗方法。因此，准确的诊断是必要的，且需要进行体格检查和病史询问之外的检查。多年来提出的检查方法数量与目前使用的数量相比，证明了这些方法存在问题。更具确定性的检查也更具侵入性、风险更大且成本更高。个人在现有检查的操作和解读方面的经验对于获得准确结果非常重要，因此针对患者的最佳检查方案因机构而异。最被认可和常用的方案包括将静脉造影作为疑似静脉血栓形成的初始和最终检查，将肺灌注显像（所有病例均使用胸部X线摄影，大多数病例使用通气显像）作为肺栓塞的筛查检查，当扫描结果不明确或临床情况与扫描结果不一致时，再进行肺血管造影。
