肺血栓栓塞症敌履诊治.ppt

肺血栓栓塞症的现状与规范化诊治 ;?一、几个相关名词与定义?;一、几个相关名词与定义;一、我国医学界一直将PTE视为一种少见病，以致临床各科医师仍缺乏对PTE足够的诊断意识，漏误诊情况极为严重。 二、PTE是一个涉及众多学科的严重疾病，我国在构建多学科防治体系方面尚存在显著欠缺，特别是对PTE的影像学及易栓症的诊断水平亟待进一步提高。 ;我国在PTE防治方面目前存在的几个主要问题; 三、 VTE的发病情况 （一）美国： 每年新发生病例约65万 住院患者25万 死亡5万 发病率约 1 ‰ 占心血管病的第三位 占全部死因的第三位 ;三、VTE的发病情况;三、VTE的发病情况;;; 35年来我院PTE年诊断例数增长趋势;;四、危险因素;四、危险因素;四、危险因素;五、病理生理 ;五、病理生理 ;六、临床表现;六、临床表现;六、临床表现;六、临床表现;六、临床表现;六、临床表现;;;七、实验室检查和影像学;七、实验室检查和影像学;（三）ECG 非特异性改变，动态改变较静态异常意义更大。 1、T波改变和ST段异常：V1-V4 2、SⅠ QⅢ TⅢ征（即I导S波加深，Ⅲ导出现Q/q波及T波倒置） 3、完全或不完全右束支传导阻滞 4、肺性P波 5、电轴右偏 6、顺钟转位 ;七、实验室检查和影像学;七、实验室检查和影像学;;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;;七、实验室检查和影像学;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;七、实验室检查和影像学;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;七、实验室检查和影像学;七、实验室检查和影像学;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;七、实验室检查和影像学;七、实验室检查和影像学;治疗前;治疗后;赵X 男性，75岁 ;2;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slide