老年慢性阻塞性肺疾病合并肺血栓栓塞症诊治进展

Progress in diagnosis and treatment for pulmonary thromboembolism in the elderly with chronic obstructive pulmonary disease

摘要:

肺血栓栓塞症（PTE）是老年慢性阻塞性肺疾病（COPD）患者的重要并发症，发病率、病死率和复发率均较高。COPD和PTE临床表现均缺乏特异性并相互重叠，易导致延迟诊断或漏诊。因此，提高诊断意识在临床上非常重要。对老年COPD合并PTE患者选择溶栓或抗凝时应充分考虑老年人的病理生理特点以及其他合并症的影响，慎重权衡病情轻重与出血风险。

Abstract:

Pulmonary thromboembolism (PTE) is a major complication in the elderly patients with chronic obstructive pulmonary disease (COPD), and is of high incidence, mortality and recurrence. The clinical manifestations of COPD and PTE were nonspecific and might overlap, and this may lead to delayed diagnosis or misdiagnosis for PTE. Therefore, it is very important to increase awareness of PTE diagnosis in clinical practice. For the elderly COPD patients complicated with PTE, physicians should give full consideration on the elderly’s pathophysiological characteristics and the impact of their complications to select thrombolytic or anticoagulant treatment, and carefully weigh the severity and risk of bleeding.