Fennerty T
Chest Clinic, Southern General Hospital, Glasgow.
BMJ. 1997 Feb 8;314(7078):425-9. doi: 10.1136/bmj.314.7078.425.
Currently, clinicians have to make decisions about how to manage pulmonary embolism on the basis of imperfect tests and assessment of odds. Management protocols that inevitably result in large numbers of patients being referred for angiography are unhelpful. Management decisions based on assessment of odds and investigation of leg veins will inevitably result in some patients who have survived a pulmonary embolus being left untreated. Current evidence suggests that for most patients this is probably not important, the clear exception being those patients with underlying cardiorespiratory disease.
目前,临床医生必须基于不完善的检查和概率评估来决定如何处理肺栓塞。那些不可避免地导致大量患者被转诊去做血管造影的管理方案并无益处。基于概率评估和对腿部静脉进行检查所做出的管理决策,将不可避免地导致一些已经从肺栓塞中存活下来的患者得不到治疗。目前的证据表明,对于大多数患者来说这可能并不重要,明显的例外是那些患有基础心肺疾病的患者。