Goodall R J, Greenfield L J
Ann Surg. 1980 Feb;191(2):219-23. doi: 10.1097/00000658-198002000-00014.
This study of 73 patients with the clinical diagnosis of thromboembolism has shown that the pulse rate, respiratory rate, and arterial partial pressure of carbon dioxide have discriminatory value in identifying the group of acutely ill patients who are most likely to have pulmonary embolism. In contrast, the clinical diagnosis of deep venous thrombosis, PaO2 chest radiography and electrocardiography which are all essential to patient management have no such value. In this series, only 29% of the patients had a pulmonary arteriogram positive for thromboembolism, but the mortality rate in this group was 33%. Pulmonary perfusion scanning has been shown to be a useful and accurate screening investigation and should be routinely employed prior to pulmonary angiography if the patient is stable hemodynamically.
这项针对73例临床诊断为血栓栓塞的患者的研究表明，脉搏率、呼吸率和动脉血二氧化碳分压在识别最有可能发生肺栓塞的急性病患者群体方面具有鉴别价值。相比之下，对于患者管理至关重要的深静脉血栓形成的临床诊断、动脉血氧分压、胸部X线摄影和心电图则没有这种价值。在该系列研究中，只有29%的患者肺血管造影显示血栓栓塞阳性，但该组的死亡率为33%。肺灌注扫描已被证明是一种有用且准确的筛查检查，如果患者血流动力学稳定，在进行肺血管造影之前应常规采用。
