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肺栓塞的治疗

Treatment of pulmonary thromboembolism

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【作者】 李艳霞张中和

【Author】 LI Yan-xia,ZHANG Zhong-he.Department of Respiratory Medicine,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China

【机构】 大连医科大学附属第一医院呼吸科

【摘要】 肺栓塞是常见的呼吸和心血管急症之一。血流动力学不稳定是大面积肺栓塞的特征,病死率达20%以上,肺栓塞治疗目标是稳定血流动力学,使肺血管再通,抢救患者的生命。肺栓塞的基本治疗是抗凝。静脉溶栓治疗是大面积肺栓塞的重要治疗方法,部分危重患者需要呼吸循环支持治疗。妊娠合并肺栓塞、肿瘤合并肺栓塞、肝素诱导的血小板减少及右心血栓等特殊情况下的肺栓塞在抗凝治疗方法上有所不同。

【Abstract】 Pulmonary embolism(PE)is a relatively common cardiovascular emergency.Haemodynamic instability is the characteristics of massive pulmonary embolism,with a mortality as high as 20%.The goals of PE treatment are to remove the thromboembolic obstruction rapidly,exert beneficial effects on haemodynamic parameters and save the lives of patients.Haemodynamic and respiratory support is of vital importance in some critically ill patients with PE.The basic treatment is anticoagulation,the methods of which are different for PE during pregnancy,among cancer patients,with right heart thrombi and with heparin-induced thrombocytopenia.

【关键词】 肺栓塞; 血栓;

【Key words】 pulmonary embolism; thrombus;

【分类号】R563.5;R453.9;R364.15;

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