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【medical-news】准确诊断肺栓塞的新措施
New recommendations for the diagnosis of Pulmonary Embolism
Diagnosis of Pulmonary Embolism (PE) is a challenging process. Because PE is only present in about one-third of those in whom it is suspected, the diagnosis must be confirmed or excluded by further testing. In an article in the December issue of The American Journal of Medicine, researchers describe the diagnostic pathways that can be used to achieve an accurate and safe diagnosis of PE.
Based on the results from the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) and other studies, these guidelines include both evidence-based recommendations and opinions based on information available at this time.
Writing in the article, Paul D. Stein, MD, states "[we] recommend stratification of all patients with suspected pulmonary embolism according to an objective probability assessment. A negative D-dimer rapid ELISA with a low or moderate probability clinical assessment can safely exclude pulmonary embolism. If pulmonary embolism is not excluded, CT angiography/CT venography is recommended by most PIOPED II investigators, although CT angiography alone is an option. In patients with discordant findings on clinical assessment and CT imaging, further evaluation depends on clinical judgment. In pregnant women and women of reproductive age, ventilation/perfusion scans are recommended by many PIOPED II investigators as the first imaging test."
In an accompanying commentary, James E. Dalen, MD, MPH, describes how various techniques for the diagnosis of PE have been introduced over the last 40 years, each with advantages and disadvantages in accuracy, risk to the patient and cost. Writing about the article, he states, "These recommendations from the PIOPED investigators will have a major impact on the diagnosis and treatment of pulmonary embolism." 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 New recommendations for the diagnosis of Pulmonary Embolism
准确诊断肺栓塞的新措施
Diagnosis of Pulmonary Embolism (PE) is a challenging process. Because PE is only present in about one-third of those in whom it is suspected, the diagnosis must be confirmed or excluded by further testing. In an article in the December issue of The American Journal of Medicine, researchers describe the diagnostic pathways that can be used to achieve an accurate and safe diagnosis of PE.
肺栓塞（PE）的诊断极富挑战性，因为只有怀疑肺栓塞的患者中只有三分之一患该病，而且确诊必须要进一步检查。12月份美国医学杂志中的一篇文章中，研究者们描述了可正确安全诊断肺栓塞的方法。
Based on the results from the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) and other studies, these guidelines include both evidence-based recommendations and opinions based on information available at this time.
在肺栓塞诊断II期前瞻性研究(PIOPED II)和其他研究的结果的基础上，该指南涵盖了括目前可以获知循证医学指南和基于信息的观点。
Writing in the article, Paul D. Stein, MD, states "[we] recommend stratification of all patients with suspected pulmonary embolism according to an objective probability assessment. A negative D-dimer rapid ELISA with a low or moderate probability clinical assessment can safely exclude pulmonary embolism. If pulmonary embolism is not excluded, CT angiography/CT venography is recommended by most PIOPED II investigators, although CT angiography alone is an option. In patients with discordant findings on clinical assessment and CT imaging, further evaluation depends on clinical judgment. In pregnant women and women of reproductive age, ventilation/perfusion scans are recommended by many PIOPED II investigators as the first imaging test."
Paul D. Stein博士在文章中写道：“我们推荐根据客观的概率评价来划分所有肺栓塞疑似病人。快速ELISA 试验D-二聚体阴性，提示有中低概率的肺栓塞可能，临床上可安全的将其排除。如果不能排除肺栓塞，大多数PIOPED II研究人员推荐行 CT血管成像和CT静脉成像，尽管也可以单独行CT血管成像。对于临床诊断与CT影像不一致的，进一步的评估仍依靠临床的判断。许多PIOPED II的研究者推荐通气/血流比筛查可作为孕妇和育龄妇女患者的首选影像学检查。
In an accompanying commentary, James E. Dalen, MD, MPH, describes how various techniques for the diagnosis of PE have been introduced over the last 40 years, each with advantages and disadvantages in accuracy, risk to the patient and cost. Writing about the article, he states, "These recommendations from the PIOPED investigators will have a major impact on the diagnosis and treatment of pulmonary embolism."
在一篇同时发表的评论中，公共卫生硕士，James E. Dalen博士，描述了近四十年来各种用于肺栓塞的检测技术，并精确的分析了各自的优缺点，对病人的风险性以及费用。对于该文章，他说：“PIOPED研究人员所推荐的指南将对响肺栓塞的诊断和治疗产生深远的影响。”
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作者:admin@医学,生命科学 2011-05-01 17:11
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