![急诊临床路径](https://wfqqreader-1252317822.image.myqcloud.com/cover/11/36535011/b_36535011.jpg)
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15. 肺 栓 塞
概 述
肺栓塞(pulmonary embolism,PE)是以各种栓子阻塞肺动脉系统为发病原因的一组疾病的总称,包括肺血栓栓塞症(pulmonary thromboembolism,PTE)、脂肪栓塞综合征、羊水栓塞和空气栓塞等。PTE为PE的最常见类型,指静脉系统或者右心的血栓阻塞肺动脉或其分支所致的疾病,以肺循环或肺功能障碍为主要表现和病理生理特征。以下是肺栓塞诊治的临床路径。
表15.1 肺栓塞的主要临床表现
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.1_59981.jpg?sign=1739290711-7QS22mZNo93okpM8zPLI3Hf15FMC8mTo-0-fd01a70fa25243398a32817c9c6f8b3d)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.1_1_59982.jpg?sign=1739290711-EQ03VhTzdZlbaWLXgT3yXpcvBwVOxLDU-0-8929f101aa8a6cfa010fb44e14eae144)
表15.2 评价肺栓塞的可能性——Wells及改良的Geneva评分
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.2_59983.jpg?sign=1739290711-khYzhTibfGeYBSqgFtq0yopzZzzZRDHM-0-af536167fbe898a27bf3db362bcae928)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.2_1_59984.jpg?sign=1739290711-zT6aShsXfJjImH3McmleZAzIAqEWpCQq-0-1f835e8b149b8a0a7fd3da08d605d18c)
表15.3 急性肺动脉主干栓塞的心脏超声表现
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.3_13053.jpg?sign=1739290711-dD00Vtf0LbgmJqwGh8ytV18RPCkHHMqS-0-cc2852499488bea6baa1ed193d26ca6d)
表15.4 紧急检查
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.4_59662.jpg?sign=1739290711-tfzwvgSSotKvJ7ckXz11MYY7tiNs6otl-0-cd46183dd16dddee8f7bc541c5b84413)
表15.5 紧急处理
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.5_13076.jpg?sign=1739290711-3tU5LJ4DSeoxmhaaJnl4ugSriXJYjUcD-0-5fd7c778c2e5b00b1353f1f6d9e91688)
表15.6 进一步治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.6_13083.jpg?sign=1739290711-1B142ZjbAODEVnbKV60sX5tmmhisVwLI-0-fae8794e19a8610ef311a11a583a8eaa)
表15.7 溶栓治疗的指征
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.7_13090.jpg?sign=1739290711-hAgbsJ8TduQmt9TAgY0yKASY85Hb4yAk-0-ea2d03dfb4d6c5af2416fd9a311ba046)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.7_1_13134.jpg?sign=1739290711-58yRRZh7KXSztpb1e11bmtvT6JkKYUf3-0-25c7bcd697908170ab655bc52d695584)