抽象的
疑似肺栓塞(PE)的新诊断工具的有效性,例如临床概率评估,血浆D-二聚体(DD)测量和下肢静脉压缩超声检查(US),尚未在疑似PE发生的患者中进行专门研究在住院期间。本研究应用了一种顺序,基于决策分析的策略,将这些仪器添加到114个连续住院患者的群组中的通风/灌注肺扫描,以便在避免有多少患者中可以避免患有肺血管造影。在这些患者的61%的非侵入方案中可以建立一个明确的诊断:正常/近常肺扫描,14%;高概率肺扫描,19%;临床概率与肺部扫描结果相结合,18%;和美国,8%。DD的特异性仅为7%,并为仅在两个患者中排除PE。39%的患者需要肺血管造影。诊断过程中PE排除患者的3个月血栓栓塞风险为0%(95%置信区间0-4.9%)。 In conclusion, a noninvasive work-up for suspected pulmonary embolism is effective in hospitalized patients, allowing to forego angiography in 61% of them, and it appears to be safe, although this should be further investigated. In contrast to outpatients, D-dimer measurement appears to be useless in hospitalized patients.