提高对急性肺栓塞的认识PPT.ppt

提高对急性肺栓塞的认识; ;;;肺梗死：(pulmonary infarction) 肺组织因肺栓塞，肺动脉或肺静脉血栓形成所引起的缺血坏死。;患病率;;;Risk Factors:;;;Proximal Deep Vein Thrombosis (DVT);;病理解剖(Pathological anatomy);;Venous Thromboembolic Disease How is it treated? Interventional radiologists can inject a medication called urokinase directly into a blocked vessel that dissolve the clot After injection of medication, the clot has dissolved shown as blood flow (black) in the vein;;;;;病理生理 (Pathological physiology);症状 (Symptom);临床分型(Clinical types) 1 突然虚脱型，1－2H死亡。 2 胸痛型，类似心肌梗死。 3 原发病恶化型 ，数小时死亡。 4 肺炎型，类似肺炎，呼吸道症状。 5 休克型，循环衰竭，数小时死亡。 6 心衰型， 7 咯血型，咯血(hemoptysis)。 8 肾衰型， 9 腹疼 10 混合型 ;临床表现(Clinical manifestation); ;心动过速——58.9－90.9％ 烦躁不安(restless),JVP?,RV S3/4 gallop,P2?，等。 ;;辅助检查（Laboratory test);;;;;CT scan;;;;Pulmonary Embolus Diagnosis with CT Angiogram In this CTA, a clot (red arrow) can be seen in the right pulmonary artery The pulmonary arteries are the main arteries taking blood to the lung This bit of clot broke off from the one in the leg ;;Deep Vein Thrombosis Diagnosis with CT Scan This CT scan after injection of X-Ray dye shows a clot in the right iliac vein (red arrow) The clot is seen as a dark area I n the centre of the normally light coloured vein;超声心动图（Echocardiography);;;;ECG检查;ECG改变可表现为;;;肺扫描;肺血管造影;实验室检查;诊断与鉴别诊断;;肺栓塞和肺梗死的鉴别诊断;预防;治疗;Low-Molecular-Weight Heparin (LMWH): Advantages;Unfractionated Heparin (UFH): Limitations;预后;结 论 ;谢谢！