Hobohm Lukas, Keller Karsten, Konstantinides Stavros
Centrum für Thrombose und Hämostase, Universitätsmedizin Mainz, Mainz, Deutschland.
Kardiologie I, Zentrum für Kardiologie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131 Mainz, Deutschland.
Z Herz Thorax Gefasschir. 2023;37(3-4):133-142. doi: 10.1007/s00398-023-00582-6. Epub 2023 May 5.
Pulmonary embolism is a frequent cardiovascular disease which in recent years has shown a reduction in the mortality but an increase in the incidence. Due to the optimization of clinical probability scores and the interpretation of the D‑dimer test, unnecessary examinations using computed tomography with respect to the exclusion of an acute pulmonary embolism can be avoided, also in pregnant women. The evaluation of the right ventricle contributes to a risk-adapted treatment. Treatment consists of anticoagulation, alone or in combination with reperfusion treatment, such as systemic thrombolysis and also catheter-assisted or surgical treatment. In addition to acute treatment of pulmonary embolisms, an adequate aftercare is important, particularly for the early detection of long-term sequelae. This review article summarizes the current recommendations of international guidelines for patients with pulmonary embolism, accompanied by clinical case examples and a critical discussion.
肺栓塞是一种常见的心血管疾病,近年来死亡率有所下降,但发病率有所上升。由于临床概率评分的优化和D-二聚体检测结果的解读,即使对于孕妇,也可以避免为排除急性肺栓塞而进行不必要的计算机断层扫描检查。对右心室的评估有助于进行风险适应性治疗。治疗包括抗凝治疗,单独使用或与再灌注治疗联合使用,如全身溶栓以及导管辅助治疗或手术治疗。除了对肺栓塞进行急性治疗外,充分的随访护理也很重要,特别是对于早期发现长期后遗症而言。这篇综述文章总结了国际指南对肺栓塞患者的当前建议,并伴有临床病例实例和批判性讨论。