![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=1739219634-hPe43m8e070nTL41TGtCZS3KFfqdo4NF-0-a5465f19ee3a797fd20dac73b1c37e1b)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.1_1_59982.jpg?sign=1739219634-em3AXNtddvlJpNRxFvWLQlNkf0MbsjVV-0-82b80cf7ef4ad0f290203a29f9ff987a)
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=1739219634-OfAatL569fjM67dBtm1pjKpJKjHF4Lcc-0-9f5e62335cfc2b5ef0118e7e44b4611c)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.2_1_59984.jpg?sign=1739219634-tHZiGshYdNT2GUrAoMDczKzYau55vq78-0-0d3ba1c8be81b21d137674f548ab6cad)
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=1739219634-681BFV1INALQDess0WsCERlKzYTstONw-0-3a9b265dd2c0de2ee632e1564c9fd475)
表15.4 紧急检查
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.4_59662.jpg?sign=1739219634-j292aDSB40jwqUcJoHhEOTeZujOSMNZQ-0-1e98b64bf8cae7f26f14cf5fba67edbb)
表15.5 紧急处理
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.5_13076.jpg?sign=1739219634-ByYuN7xihUsSI4Ger5YnBhhIFAgHaG5J-0-15a548305fccdf3adaf0bed096899e04)
表15.6 进一步治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.6_13083.jpg?sign=1739219634-tBKhUqtOV8FcbbRfuaiCZyZhIeJF1HIR-0-3fc2c76fc3e1f941b2ed21854c9a65ea)
表15.7 溶栓治疗的指征
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.7_13090.jpg?sign=1739219634-gr0h4WVcLAdFmb4yo9goxvJ32NDotEBw-0-260a38ff6632ba42ff56c1ad996b88b3)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T15.7_1_13134.jpg?sign=1739219634-0PxNiypkrBodsvMUM5vVkZdaKxJvObhq-0-7a9db0982859c4337f81d790dd5b6b67)