肺栓塞小讲课.ppt

1、Chai Lin,Acute pulmonary embolis,Emergency department of Shiyan Taihe Hospital,Definition,Pulmonary embolism(PE): Embolus from circulation or right heart shedding and blocking obstruction of the pulmonary artery and its branches cause pulmonary circulation obstacle. The most common pulmonary embolus

2、 for thrombosis, blood clots caused by pulmonary embolism or pulmonary embolism.,Superior vena cava,Clinical symptoms,Patients with sudden unexplained collapse, pale, cold sweat, difficulty breathing, chest pain, cough, and cerebral hypoxia symptoms such as extreme anxiety, fatigue, nausea, convulsi

3、ons and coma. The clinical symptoms and signs of PE are not obvious, and it is likely to be missed. The clinical manifestations of patients with PE, must immediately further objective examination.,Pleuritic chest pain,Pain in the chest,Hemoptysis,Vertigo,half or both lower extremities pai,Unilateral

4、 limb swelling,Inferior vena cava,Pulmonary artery,Embolus,An admissions of patients with chest pain,Lower extremity venous color Doppler ultrasound,Lung ventilation / perfusion scan,Pulmonary artery angiography,Treatment -acute phase,AnticoagulationThe aim of anticoagulation therapy in patients wit

5、h acute PE is to prevent early death and recurrence or fatal VTE (venous thromboembolism). Standard anticoagulant therapy for at least 3 months. During this period, the acute phase of treatment was used in the first 5-10 days of parenteral anticoagulation (common heparin, low molecular weight hepari

6、n). Then the vitamin K antagonist was used to maintain the treatment, and the initial treatment of the drug should be overlapped with heparin for injection.,Anti coagulation time,The goal of anticoagulant therapy in patients with pulmonary embolism is to prevent the recurrence of venous thromboembol

7、ism. In most cases, the use of vitamin K antagonists, while in the patients with VTE combined tumor, the application of low molecular weight heparin.,Thrombolysis,Compared with the single application of common heparin, acute PE thrombolysis can recover the pulmonary blood flow faster. Early release

8、of pulmonary vascular occlusion can make the pulmonary arterial pressure and resistance decreased rapidly, and can improve the right ventricular function.,dysfunction of blood coagulation ;,Ischemic stroke,Hemorrhagic Stroke,Severe trauma,contraindicatio,Other treatment.,Thrombectomy Percutaneous ca

9、theter intervention: the goal of interventional therapy is to remove the thrombus in the main pulmonary artery, thereby enabling the right ventricular function recovery, and then improve the symptoms and survival rate. For thrombolytic therapy in patients with contraindication, interventional therap

10、y can chooseCava filter: the absolute contraindication of anticoagulant drugs and received enough intensity anticoagulation therapy still relapse of acute recurrent PE patients can choose cava filter implantation. Observational studies have indicated that the implantation of the venous filter may reduce the mortality of PE in acute phase and reduce the risk of VTE recurrence.,