危重症肺血栓栓塞症的救治与管理策略  

Treatment and management strategies for critical pulmonary thromboembolism

作　　者：席霖枫 陶禹至 刘敏[3] 季颖群 翟振国 Xi Linfeng;Tao Yuzhi;Liu Min;Ji Yingqun;Zhai Zhenguo(China-Japan Friendship Hospital Clinical Medical School,Capital Medical University,Beijing 100029,China;The First Bethune Hospital of Jilin University,Changchun 130021,China;Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Respiratory and Critical Care Medicine,East Hospital Affiliated to Tongji University,Shanghai 200120,China;National Center for Respiratory Medicine,State Key Laboratory of Respiratory Health and Multimorbidity,National Clinical Research Center for Respiratory Disease,Institute of Respiratory Medicine,Chinese Academy of Medical Sciences,Department of Pulmonary and Critical Care Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]首都医科大学,中日友好临床医学院,北京100029 [2]吉林大学白求恩第一医院,长春130021 [3]同济大学附属东方医院呼吸与危重症医学科,上海200120 [4]国家呼吸医学中心,呼吸和共病全国重点实验室,国家呼吸疾病临床医学研究中心,中国医学科学院呼吸病学研究院,中日友好医院呼吸与危重症医学科,北京100029中日友好医院放射诊断科,北京100029 [5]国家呼吸医学中心,呼吸和共病全国重点实验室,国家呼吸疾病临床医学研究中心,中国医学科学院呼吸病学研究院,中日友好医院呼吸与危重症医学科,北京100029

出　　处：《中华血管外科杂志》2025年第1期59-66,共8页Chinese Journal of Vascular Surgery

基　　金：国家重点研发计划(2023YFC2507200);中央高水平医院临床科研基金(2022-NHLHCRF-LX-01-0203);中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-061);国家自然科学基金(82272081)。

摘　　要：危重症肺血栓栓塞症(PTE)是一种危及生命的急症,其特征为急性肺循环障碍和右心负荷急剧增加。此类患者死亡风险很高,因此需要尽早识别和及时评估;在管理上,应强调多学科团队协作,制定个体化治疗方案,并根据病情变化及时调整治疗措施。本文综述了危重症PTE的定义、流行病学、发生机制、早期识别与病情评估及包括再灌注治疗和多种高级生命支持手段在内的救治策略,旨在提高危重症PTE的救治成功率,改善患者的临床结局。Critical pulmonary thromboembolism(PTE)is a life-threatening emergency characterized by acute pulmonary circulation dysfunction and a rapid increase in right heart load.Patients with critical PTE carries a high risk of death,therefore,early identification and timely assessment are required.In terms of management,emphasis should be put on multidisciplinary teamwork,customized treatment,and timely treatment adaptation to different conditions.This article reviews the definition,epidemiology,pathogenesis,early recognition,and assessment of critical PTE,together with the treatment strategies,including reperfusion therapy and multiple advanced life support techniques,aiming to enhance the survival rate of critical PTE and improve the clinical outcomes of the patients.

关 键 词：肺血栓栓塞症 危重症 肺栓塞快速反应团队 救治策略 

分 类 号：R56[医药卫生—呼吸系统]