老年肺栓塞临床诊治进展

急性肺栓塞在老年患者中属于高发疾病，并可能严重危及生命，其危险因素、临床表现常因基础疾病的掩盖而造成误诊或漏诊。当患者出现特异性较高的易患因素及晕厥表现，应高度警惕肺栓塞的发生，并根据临床具体条件确定诊查策略，选择合适的诊断手段，尽早确定或排除诊断。抗凝治疗仍是所有肺栓塞患者的基本治疗方法，当血流动力学不稳定时，可以考虑启动溶栓治疗。老年肺栓塞的治疗更强调个体化施治以最大限度地提高治疗收益，降低治疗风险。

The Progression of Clinical Diagnosis and Treatment of Elderly Pulmonary Embolism

Acute pulmonary thromboembolism （APE） is a roughly common and potentially life-threatening condition in the elderly, and is easily overlooked and misdiagnosed because of the similar risk factors and clinical manifestations that are mimic with other underlying diseases. APE should be highly suspected when the patient has relatively higher special risk factors,as well the symptom of syncope. In order to promptly confirm or exclude APE, based on perspective clinic condition, a detailed examination strategy including appropriate diagnostic selections ought to be established. Among the various treatment, anticoagulant therapy is still the primary choice for all the patients with pulmonary embolism. Thrombolytic therapy should be initiated when hemodynamic instability persists. Collectively, it is notably very important to emphasize individualized management in elderly APE patients, with the aim of maximizing beneficial therapeutic effects and meanwhile minimizing risks of complications.