Heinrich F
Medizinische Klinik, Krankenhauses Fürst-Strium-Stiftung Bruchsal.
Z Gesamte Inn Med. 1993 Nov;48(11):518-24.
Pulmonary embolism is a frequent and malignant complication of other diseases. To consider this is the most important step. ECG, pO2/pCO2, chest X-ray are used for differential diagnosis; pulmonary embolism is directly confirmed by scintigraphy, echocardiography, pulmonary angiography and pulmonary artery catheterisation, supplemented by examination of lower venous system (sonography, phlebography). Small emboli should also be noted as a signal of dangerous recurrence. The choice of the therapeutic method (embolectomy, fibrinolysis, anticoagulation) depends on the severity of pulmonary embolism, available methods and present contraindications. Depending upon the severity and general condition of the patient, it may be necessary to disregard possible contraindications against therapeutic methods that may cause desobliteration. Anticoagulation is used as prophylactic method, in exceptional cases a blockade is applied to the vena cava inferior.
肺栓塞是其他疾病常见且严重的并发症。认识到这一点是最重要的一步。心电图、氧分压/二氧化碳分压、胸部X线用于鉴别诊断；肺栓塞通过闪烁扫描、超声心动图、肺血管造影和肺动脉导管插入术直接确诊，辅以对下肢静脉系统的检查（超声检查、静脉造影）。小栓子也应被视为危险复发的信号。治疗方法（栓子切除术、纤维蛋白溶解、抗凝）的选择取决于肺栓塞的严重程度、可用方法和当前禁忌证。根据患者的严重程度和一般状况，可能有必要不顾及针对可能导致再通的治疗方法的潜在禁忌证。抗凝用作预防方法，在特殊情况下对下腔静脉进行阻断。
