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中华介入放射学电子杂志 ›› 2023, Vol. 11 ›› Issue (02) : 155 -158. doi: 10.3877/cma.j.issn.2095-5782.2023.02.010

综述

无症状肺栓塞的诊断与治疗进展
史亚东1, 顾建平1,()   
  1. 1. 210006 江苏南京,南京医科大学附属南京医院(南京市第一医院)介入血管科
  • 收稿日期:2022-09-10 出版日期:2023-05-25
  • 通信作者: 顾建平
  • 基金资助:
    国家自然科学基金(81871463)

Progress in diagnosis and treatment for silent pulmonary embolism

Yadong Shi1, Jianping Gu1,()   

  1. 1. Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Jiangsu Nanjing 210006, China
  • Received:2022-09-10 Published:2023-05-25
  • Corresponding author: Jianping Gu
引用本文:

史亚东, 顾建平. 无症状肺栓塞的诊断与治疗进展[J]. 中华介入放射学电子杂志, 2023, 11(02): 155-158.

Yadong Shi, Jianping Gu. Progress in diagnosis and treatment for silent pulmonary embolism[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(02): 155-158.

无症状肺栓塞是深静脉血栓常见的并发症。虽然无症状肺栓塞的后果远没有症状性肺栓塞的严重,但是无症状肺栓塞可能会影响静脉血栓栓塞症的治疗方案。此外,无症状肺栓塞的发生可能会增加静脉血栓栓塞症的复发率并造成远期的肺动脉高压。既往文献及指南大多侧重于症状性肺栓塞的诊治,而对无症状肺栓塞关注甚少。为了能更好地认识该疾病,文章就无症状肺栓塞的发病率、筛查、危险因素和治疗方案进行综述。

Silent pulmonary embolism (SPE) is a common complication in deep vein thrombosis (DVT). Although the consequences of SPE are less severe than symptomatic PE, the treatment regimen for venous thromboembolism (VTE) may be influenced by concomitant SPE. Moreover, SPE may be associated with an increased risk of VTE recurrence and long-term pulmonary hypertension. Most previous studies and guidelines focused on the diagnosis and treatment for symptomatic PE, whereas the concerns regarding SPE were limited. In order to have a better understanding of SPE, the present review focused on the incidence, screening, risk factors and treatment for SPE.

[1]
Huisman MV, Barco S, Cannegieter SC, et al. Pulmonary embolism[J]. Nat Rev Dis Primers, 2018, 4: 18028.
[2]
Kistner RL, Ball JJ, Nordyke RA, et al. Incidence of pulmonary embolism in the course of thrombophlebitis of the lower extremities[J]. Am J Surg, 1972, 124(2): 169-176.
[3]
Sommers BD. Routine screening for silent pulmonary embolism is harmful and unnecessary[J]. Am J Med, 2010, 123(12): e15 author reply e17.
[4]
Ahmad N, Srinivasan K, Moudgil H. Looking for asymptomatic pulmonary embolism in patients with deep vein thrombosis: is it the right practice?[J]. Am J Med, 2011, 124(1): e15.
[5]
Tzoran I, Saharov G, Brenner B, et al. Silent pulmonary embolism in patients with proximal deep vein thrombosis in the lower limbs[J]. J Thromb Haemost, 2012, 10(4): 564-571.
[6]
Jimenez D, Diaz G, Marin E, et al. The risk of recurrent venous thromboembolism in patients with unprovoked symptomatic deep vein thrombosis and asymptomatic pulmonary embolism[J]. Thromb Haemost, 2006, 95(3): 562-566.
[7]
Monreal M, Buller H, Lensing AW, et al. Should patients with deep vein thrombosis alone be treated as those with concomitant asymptomatic pulmonary embolism? A prospective study[J]. Thromb Haemost, 2002, 88(6): 938-942.
[8]
Stein PD, Matta F, Musani MH, et al. Silent pulmonary embolism in patients with deep venous thrombosis: a systematic review[J]. Am J Med, 2010, 123(5): 426-431.
[9]
Hughes MJ, Stein PD, Matta F. Silent pulmonary embolism in patients with distal deep venous thrombosis: systematic review[J]. Thromb Res, 2014, 134(6): 1182-1185.
[10]
Krutman M, Wolosker N, Kuzniec S, et al. Risk of asymptomatic pulmonary embolism in patients with deep venous thrombosis[J]. J Vasc Surg Venous Lymphat Disord, 2013, 1(4): 370-375.
[11]
Lopez-Beret P, Pinto JM, Romero A, et al. Systematic study of occult pulmonary thromboembolism in patients with deep venous thrombosis[J]. J Vasc Surg, 2001, 33(3): 515-521.
[12]
Li F, Wang X, Huang W, et al. Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb[J]. Phlebology, 2014, 29(7): 442-446.
[13]
Dentali F, Ageno W, Becattini C, et al. Prevalence and clinical history of incidental, asymptomatic pulmonary embolism: a meta-analysis[J]. Thromb Res, 2010, 125(6): 518-522.
[14]
Investigators P. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED)[J]. JAMA, 1990, 263(20): 2753-2759.
[15]
Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism[J]. N Engl J Med, 2006, 354(22): 2317-2327.
[16]
García-Fuster MJ, Fabia MJ, Furió E, et al. Should we look for silent pulmonary embolism in patients with deep venous thrombosis?[J]. BMC Cardiovascular Disorders 2014, 14: 178-182.
[17]
Shi Y, Wang T, Yuan Y, et al. Silent pulmonary embolism in deep vein thrombosis: relationship and risk factors[J]. Clin Appl Thromb Hemost, 2022, 28: 10760296221131034.
[18]
Kakkos SK, Gohel M, Baekgaard N, et al. Editor's choice - european society for vascular surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis[J]. Eur J Vasc Endovasc Surg, 2021, 61(1): 9-82.
[19]
Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the european respiratory society (ERS)[J]. Eur Heart J, 2020, 41(4): 543-603.
[20]
Huisman MV, Buller HR, Ten Cate JW, et al. Unexpected high prevalence of silent pulmonary embolism in patients with deep venous thrombosis[J]. Chest, 1989, 95(3): 498-502.
[21]
Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for vte disease: chest guideline and expert panel report[J]. Chest, 2016, 149(2): 315-352.
[22]
中国医师协会介入医师分会, 中华医学会放射学分会介入专业委员会,中国静脉介入联盟. 下腔静脉滤器置入术和取出术规范的专家共识(第2版)[J]. 中华医学杂志, 2020, 100(27): 2092-2101.
[23]
Musani MH. Asymptomatic saddle pulmonary embolism: case report and literature review[J]. Clin Appl Thromb Hemost, 2011, 17(4): 337-339.
[24]
Pepke-Zaba J, Delcroix M, Lang I, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry[J]. Circulation, 2011, 124(18): 1973-1981.
[25]
Meignan M, Rosso J, Gauthier H, et al. Systematic lung scans reveal a high frequency of silent pulmonary embolism in patients with proximal deep venous thrombosis[J]. Arch Intern Med, 2000, 160(2): 159-164.
[26]
Boc A, Vene N, Stalc M, et al. Unprovoked proximal venous thrombosis is associated with an increased risk of asymptomatic pulmonary embolism[J]. Thromb Res, 2014, 133(6): 1011-1015.
[27]
Partsch H, Kechavarz B, Mostbeck A, et al. Frequency of pulmonary embolism in patients who have iliofemoral deep vein thrombosis and are treated with once- or twice-daily low-molecular-weight heparin[J]. J Vasc Surg, 1996, 24(5): 774-782.
[28]
Jin S, Sun Z, Li X, et al. May-Thurner syndrome and the risk of pulmonary embolism in patients with acute deep venous thrombosis[J]. J Vasc Surg Venous Lymphat Disord, 2018, 6(4): 433-440 e1.
[29]
Vicent L, Martin De La Mota Sanz D, Rosillo N, et al. Sex differences in temporal trends in main and secondary pulmonary embolism diagnosis and case fatality rates: 2003—2019[J]. Eur Heart J Qual Care Clin Outcomes, 2022,Epub ahead of print,DOI: 10.1093/ehjqcco/qcac020.
[30]
Tagalakis V, Kondal D, Ji Y, et al. Men had a higher risk of recurrent venous thromboembolism than women: a large population study[J]. Gend Med, 2012, 9(1): 33-43.
[31]
Stevens SM, Woller SC, Kreuziger LB, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report[J]. Chest, 2021, 160(6): e545-e608.
[32]
Lyman GH, Carrier M, Ay C, et al. American society of hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer[J]. Blood Adv, 2021, 5(4): 927-974.
[33]
Li FH, Zhao Y, Wang XH, et al. Risk factors associated with symptomatic pulmonary embolism of catheter directed thrombolysis for lower extremity deep venous thrombosis[J]. Eur J Vasc Endovasc Surg, 2015, 50(5): 658-663.
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