Mlczoch J, Mlczoch F, Morawetz F
Aktuelle Gerontol. 1979 Nov;9(11):511-7.
Pulmonary embolism has a high incidence in old patients and is often not recognized. In most cases the embolism is of unknown origin, although the deep venous system of the lower extremities is involved in almost 95%. The diagnostic procedure consists of evaluation of clinical symptoms and findings. ECG and chest X-ray are often not conclusive. Confirmation of the diagnosis is possible by ventilation-perfusion scanning of the lung. Pulmonary angiography is of no value in the elderly patient, because of the lack of consequences. Besides local therapy of a thrombosis, therapy consists of administration of heparin, while oral anticoagulation should be used only with precaution. The efficacy of platelet aggregation inhibiting substances remains to be determined. The main point are prophylactic measures in patients with risk factors or in high risk situation.
肺栓塞在老年患者中发病率较高，且常未被识别。在大多数情况下，栓塞的起源不明，尽管几乎95%的病例涉及下肢深静脉系统。诊断程序包括对临床症状和体征的评估。心电图和胸部X线检查往往不能确诊。通过肺部通气灌注扫描有可能确诊。由于老年患者后果不佳，肺血管造影对其无价值。除了对血栓进行局部治疗外，治疗包括使用肝素，而口服抗凝治疗应谨慎使用。血小板聚集抑制物质的疗效仍有待确定。重点是对有危险因素的患者或处于高危情况的患者采取预防措施。
