首页 中华结核和呼吸杂志 2019年42卷2期 急性致死性肺栓塞所致心脏骤停溶栓诊治进展
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急性致死性肺栓塞所致心脏骤停溶栓诊治进展
宋平兰 
王晓慧
陈虹 
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DOI： 10.3760/cma.j.issn.1001-0939.2019.02.011
Advances in diagnosis and thrombolytic treatment of cardiac arrest due to acute fatal pulmonary embolism
Song Pinglan
Wang Xiaohui
Chen Hong
Authors Info & Affiliations
Song Pinglan
Wang Xiaohui
Chen Hong
·
DOI： 10.3760/cma.j.issn.1001-0939.2019.02.011
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摘要
急性致死性肺栓塞（FPE）是引起心脏骤停的重要病因，早期诊断和溶栓治疗可显著改善其预后，但溶栓可能导致出血风险增加，甚至颅内出血。目前FPE所致心脏骤停在诊断及治疗上尚无统一共识，本文综述了溶栓作为一种治疗方案用于FPE所致心脏骤停人群，通过对疑诊或确诊FPE特征、溶栓疗效及安全性、溶栓时机、溶栓剂类型及剂量、其他治疗方式等方面进行分析，提高FPE所致心脏骤停早期诊断率、早期溶栓率、降低病死率。
引用本文
宋平兰,王晓慧,陈虹. 急性致死性肺栓塞所致心脏骤停溶栓诊治进展[J]. 中华结核和呼吸杂志,2019,42(2)：129-133.
DOI:10.3760/cma.j.issn.1001-0939.2019.02.011PERMISSIONS
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急性致死性肺栓塞（acute fatal pulmonary embolism，FPE）是指一组以心脏骤停、休克、晕厥、严重呼吸困难及难以纠正的低氧血症为表现的疾病，是心脏骤停的常见原因之一。溶栓药物有快速溶解肺动脉血栓从而迅速降低肺动脉压力及改善右心室功能的潜力，因此理论上可以改善FPE所致心脏骤停患者的临床结局，但可能增加出血风险。使用溶栓药物的决定可能会因心脏骤停病因诊断的不确定性而复杂化。临床医生必须依靠临床判断，结合病史、体格检查和床旁诊断工具的有限数据，快速识别诊断FPE，并评估溶栓治疗的风险-获益比。早期诊断和及时溶栓治疗是改善预后的关键。
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备注信息
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陈虹，Email：
mocdef.qabq966533714
B
所有作者均声明不存在利益冲突
C
重庆市卫计委重点课题 (2015ZDXM001)
重庆市卫计委卫生适宜技术 (2016jstg006，2017jstg31，2018jstg012)
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