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印度肺栓塞的挑战、建议与流行病学:一项叙述性综述

Challenges, Recommendations, and Epidemiology of Pulmonary Embolism in India: A Narrative Review.

作者信息

Shetty Sadanand M, Vora Agam, George Robbie, M Vidita

机构信息

Cardiology, Karamshibhai Jethabhai Somaiya Super Specialty Institute, Mumbai, IND.

Pulmonology, Vora Clinic, Mumbai, IND.

出版信息

Cureus. 2024 Jul 9;16(7):e64195. doi: 10.7759/cureus.64195. eCollection 2024 Jul.

Abstract

An embolized clot that travels to the lungs from the legs or, less commonly, other parts of the body (known as deep vein thrombosis or DVT) causes pulmonary embolism (PE), which is characterized by obstruction of blood flow to the pulmonary artery. As PE has the propensity to masquerade as various illnesses affecting both the cardiovascular (CV) and the respiratory system, it is crucial to identify PE at the earliest. Appropriate diagnosis of PE may lead to earlier treatment and improved patient outcomes. While pulmonary angiography remains the established gold standard for diagnosing PE, the contemporary standard of care for this condition is the computed tomography pulmonary angiogram (CTPA). Anticoagulation therapy is the fundamental strategy for managing PE, with the forefront of treatment being the use of novel and upcoming oral anticoagulants known as non-vitamin K antagonist oral anticoagulants (NOACs). The NOACs provide a practical single-drug treatment strategy, which does not hinder the patient's lifestyle and domestic responsibilities. Although PE may be fatal, early detection may lead to effective management. Despite that, mortality and morbidity associated with PE are very high in India. The awareness among Indian healthcare professionals about PE should be improved, and unified pan-country diagnostic and management guidelines should be formulated to tackle the country's PE burden.

摘要

从腿部或(较少见地)身体其他部位(即深静脉血栓形成或DVT)游走至肺部的栓塞性凝块会引发肺栓塞(PE),其特征是肺动脉血流受阻。由于PE容易伪装成影响心血管(CV)和呼吸系统的各种疾病,尽早识别PE至关重要。对PE进行恰当诊断可能会带来更早的治疗并改善患者预后。虽然肺血管造影术仍是诊断PE的既定金标准,但目前针对这种病症的标准治疗方法是计算机断层扫描肺动脉造影(CTPA)。抗凝治疗是管理PE的基本策略,治疗的前沿是使用新型且即将上市的口服抗凝剂,即非维生素K拮抗剂口服抗凝剂(NOACs)。NOACs提供了一种实用的单药治疗策略,不会妨碍患者的生活方式和家庭责任。尽管PE可能致命,但早期检测可能会带来有效的管理。尽管如此,在印度,与PE相关的死亡率和发病率非常高。印度医疗保健专业人员对PE应提高认识,并应制定统一的全国性诊断和管理指南,以应对该国的PE负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2306/11310498/771fa39c04b6/cureus-0016-00000064195-i01.jpg

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