\u75c5\u53f2\u7b80\u4ecb<\/p>\n
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\u5165\u9662\u68c0\u67e5\uff1a\u9885\u8111CT\u5e73\u626b\uff1a<\/p>\n
1.\u53f3\u4fa7\u98a7\u9aa8\u5f13\u9aa8\u6298\uff1b<\/p>\n<\/li>\n
2.\u53f3\u4fa7\u989c\u9762\u90e8\u3001\u989d\u989e\u9876\u90e8\u3001\u773c\u7736\u5468\u56f4\u8f6f\u7ec4\u7ec7\u80bf\u80c0\u3001\u79ef\u6c14\uff1b<\/p>\n<\/li>\n
3.CT\u5e73\u626b\u672a\u89c1\u8111\u632b\u88c2\u4f24\u53ca\u9885\u5185\u8840\u80bf\u5f81\u8c61\u3002<\/p>\n<\/li>\n
\u80f8\u8179\u90e8\u3001\u76c6\u8154CT\u793a\uff1a<\/p>\n<\/li>\n
1.\u80f8\u90e8CT\u5e73\u626b\u53cc\u80ba\u672a\u89c1\u660e\u663e\u5f02\u5e38\uff1b<\/p>\n<\/li>\n
2.\u809d\u810f\u3001\u813e\u810f\u3001\u80f0\u817a\u53ca\u53cc\u80beCT\u5e73\u626b\u672a\u89c1\u5f02\u5e38\uff1b<\/p>\n<\/li>\n
3.\u76c6\u8154CT\u5e73\u626b\u672a\u89c1\u5f02\u5e38\u5f81\u8c61\u3002<\/p>\n<\/li>\n
\u53f3\u4fa7\u80a1\u9aa8\u6b63\u4fa7\u4f4d\u5e73\u7247\uff1a<\/p>\n<\/li>\n
1.\u53f3\u4fa7\u80a1\u9aa8\u4e2d\u6bb5\u7c89\u788e\u6027\u9aa8\u6298\uff1b<\/p>\n<\/li>\n
2.\u5de6\u4fa7\u80a1\u9aa8\u9aa8\u8d28\u7ed3\u6784\u672a\u89c1\u660e\u663e\u5f02\u5e38X\u7ebf\u5f81\u8c61\u3002<\/p>\n<\/li>\n
\u521d\u6b65\u8bca\u65ad\uff1a<\/p>\n<\/li>\n
1.\u53f3\u4fa7\u80a1\u9aa8\u5e72\u7c89\u788e\u6027\u9aa8\u6298\uff1b<\/p>\n<\/li>\n
2.\u53f3\u4fa7\u98a7\u9aa8\u5f13\u9aa8\u6298\uff1b<\/p>\n<\/li>\n
3.\u53f3\u773c\u949d\u632b\u4f24\uff1a\u773c\u7751\u635f\u4f24\uff1b<\/p>\n<\/li>\n
4.\u53f3\u4fa7\u989e\u90e8\u76ae\u80a4\u88c2\u4f24\u7f1d\u5408\u672f\u540e\uff1b<\/p>\n<\/li>\n
4.\u5168\u8eab\u591a\u5904\u76ae\u80a4\u64e6\u4f24\uff08\u53f3\u4fa7\u9ac2\u90e8\u3001\u53f3\u4fa7\u5927\u817f\u3001\u5c0f\u817f\u3001\u5de6\u4fa7\u8e1d\u90e8\uff09\uff1b<\/p>\n<\/li>\n
5.\u5168\u8eab\u591a\u5904\u8f6f\u7ec4\u7ec7\u635f\u4f24\uff1b<\/p>\n<\/li>\n
6.\u8fdf\u53d1\u6027\u5934\u80f8\u8179\u810f\u5668\u635f\u4f24\u5f85\u6392\uff1b<\/p>\n<\/li>\n
7.\u53f3\u4fa7\u5c0f\u817f\u9aa8\u6298\u5f85\u6392\u3002<\/p>\n<\/li>\n
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\u8fd9\u65f6\u533b\u751f\u670b\u53cb\u5c31\u95ee\uff1a\u808c\u95f4\u9759\u8109\u8840\u6813\uff0c\u4e0a\u4e0d\u4e0a\u6297\u51dd\u836f\uff1f\u7528\u4ec0\u4e48\u5408\u9002\uff1f\u53e3\u670d\u8fd8\u662f\u9759\u8109\uff1f\u60f3\u53e3\u670d\u5229\u4f10\u6c99\u73ed\u5242\u91cf\u5982\u4f55\uff1f<\/p>\n
\u6211\u67e5\u67e5\u8d44\u6599\u54c8~\u4e0b\u80a2\u8840\u6813\u9759\u8109\u4e0e\u80ba\u8840\u6813\u7684\u5173\u7cfb\u80ba\u8840\u6813\u6813\u585e(PTE)\u662f\u5e38\u89c1\u7684\u4e34\u5e8a\u6025\u75c7\uff0c\u662f\u8111\u5352\u4e2d\u548c\u5fc3\u808c\u6897\u6b7b\u4e4b\u540e\u7684\u5168\u7403\u7b2c3\u5927\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u539f\u56e0 [1]\u3002\u4e34\u5e8a\u7814\u7a76[2]\u8868\u660e\uff0c\u7ea6 90% \u7684 PTE \u6e90\u81ea\u4e0b\u80a2\u6df1\u9759\u8109\u8840\u6813\u5f62\u6210( DVT)\u7684\u8131\u843d\u548c\u8fc1\u79fb\uff0c50%\uff5e60%\u7684DVT\u6709\u53d1\u751fPTE\u7684\u53ef\u80fd\uff0c\u4e24\u8005\u7edf\u79f0\u4e3a\u9759\u8109\u8840\u6813\u6813\u585e\u75c7(VTE)\u3002DVT\u6839\u636e\u8840\u6813\u5f62\u6210\u7684\u7d2f\u53ca\u8303\u56f4\u5206\u4e3a\u8fd1\u7aefDVT(\u7d2f\u53ca\u8158\u9759\u8109\u3001\u80a1\u9759\u8109\u548c\u9ac2\u9759\u8109)\u548c\u8fdc\u7aefDVT(\u7d2f\u53ca\u80eb\u524d\u9759\u8109\u3001\u80eb\u540e\u9759\u8109\u3001\u8153\u9759\u8109\u4ee5\u53ca\u808c\u95f4\u9759\u8109)\u3002<\/p>\n
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\u5176\u7814\u7a76\u7ed3\u8bba\u5f97\u51fa\uff1a<\/p>\n
1\u3001\u8170\u690e\u540e\u8def\u51cf\u538b\u690d\u9aa8\u878d\u5408\u624b\u672f\u5982\u679c\u4ec5\u5b58\u5728\u5c0f\u817f\u808c\u95f4\u9759\u8109\u8840\u6813\u5219\u4e0d\u9700\u6297\u51dd\u6cbb\u7597\uff1b<\/p>\n
2\u3001\u884c\u5168\u9acb\u3001\u819d\u5173\u8282\u7f6e\u6362\u624b\u672f\u60a3\u8005\u5982\u679c\u5b58\u5728\u5c0f\u817f\u808c\u95f4\u9759\u8109\u8840\u6813\u5219\u672f\u524d\u9700\u8981\u89c4\u5f8b\u6297\u51dd\u6cbb\u7597\uff1b<\/p>\n
3\u3001\u80a1\u9aa8\u7c97\u9686\u95f4\u9aa8\u6298\u60a3\u8005\u672f\u540e\u65e9\u671f\u8fdb\u884c\u4e0b\u80a2\u529f\u80fd\u953b\u70bc\u5bf9\u4e8e\u9884\u9632\u4e0b\u80a2\u6df1\u9759\u8109\u8840\u6813\u66f4\u5177\u6709\u4e34\u5e8a\u610f\u4e49\u3002<\/p>\n
\u4e5f\u6709\u5b66\u8005\u53d1\u73b0\u4e34\u5e8a\u5b58\u5728\u8bca\u65ad\u8840\u6813\u540e\u201c\u8fc7\u6fc0\u201d\u53cd\u5e94\uff0c\u8ba4\u4e3a\u5bf9\u5355\u7eaf\u5c0f\u817f\u6bb5\u808c\u95f4\u9759\u8109\u8840\u6813\u60a3\u8005\u8fdb\u884c\u5236\u52a8\u60a3\u80a2\u3001\u5fc3\u7535\u76d1\u62a4\u4ea7\u751f\u4e86\u533b\u7597\u8d44\u6e90\u7684\u6d6a\u8d39\uff0c\u544a\u77e5\u75c5\u5371\u7b49\u4e00\u7cfb\u5217\u63aa\u65bd\u5bf9\u75c5\u4eba\u9020\u6210\u4e86\u6781\u5927\u7684\u5fc3\u7406\u8d1f\u62c5\uff0c\u53cd\u800c\u53ef\u80fd\u4f1a\u5bf9\u75be\u75c5\u7684\u9884\u540e\u9020\u6210\u4e0d\u826f\u5f71\u54cd[5]\u3002<\/p>\n
\u4e00\u9879\u7efc\u8ff0\u663e\u793a[6]\uff0c\u6709\u5b66\u8005\u8ba4\u4e3a\u6297\u51dd\u6cbb\u7597\u53ef\u4ee5\u964d\u4f4eMCVT\u60a3\u8005\u7684\u8840\u6813\u8fdb\u5c55\u4ee5\u53caPTE\u7684\u53d1\u751f\u7387\uff1b\u4e5f\u6709\u5b66\u8005\u8ba4\u4e3a\u662f\u5426\u6297\u51dd\u4e0eMCVT\u5408\u5e76PTE\u53d1\u751f\u65e0\u5173\uff0c\u4e0d\u540c\u89c2\u70b9\u90fd\u6709\u5404\u81ea\u7684\u7814\u7a76\u6210\u679c\u652f\u6301\uff0c\u6545MCVT\u76f8\u5173PTE\u7684\u771f\u6b63\u98ce\u9669\u5c1a\u672a\u786e\u5b9a\u3002<\/p>\n
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2021\u5e74\u7f8e\u56fd\u80f8\u79d1\u533b\u5e08\u534f\u4f1a(ACCP)\u6307\u5357\u7684\u7b2c2\u6b21\u66f4\u65b0\u5efa\u8bae[7]:\u5bf9IDDVT\u60a3\u8005\uff0c\u82e5\u60a3\u8005\u6ca1\u6709\u4e25\u91cd\u75c7\u72b6\u6216\u8840\u6813\u6ca1\u6709\u5411\u8fd1\u7aef\u5ef6\u4f38\u7684\u5371\u9669\u56e0\u7d20\uff0c\u5219\u5efa\u8bae2\u5468\u5185\u8d85\u58f0\u968f\u8bbf\u4f18\u4e8e\u6297\u51dd\u6cbb\u7597\uff0c\u76f8\u53cd\u5219\u5efa\u8bae\u6297\u51dd\u3002\u5efa\u8bae\u6709\u4ee5\u4e0b\u56e0\u7d20\u8005\u5e94\u8003\u8651\u6297\u51dd\u6cbb\u7597\uff1aD-\u4e8c\u805a\u4f53\u5448\u9633\u6027\u3001\u8840\u6813\u5f62\u6210\u5e7f\u6cdb(\u957f\u5ea6\uff1e5cm\uff0c\u7d2f\u53ca\u591a\u6761\u9759\u8109\uff0c\u6700\u5927\u76f4\u5f84\uff1e7mm)\u3001\u8840\u6813\u9760\u8fd1\u8fd1\u7aef\u9759\u8109\u3001\u6ca1\u6709\u53ef\u9006\u7684\u8bf1\u53d1\u56e0\u7d20\u7684DVT\u3001\u60a3\u8005\u60a3\u6709\u6d3b\u52a8\u6027\u764c\u75c7\u3001\u60a3\u8005\u6709VTE\u75c5\u53f2\u3001\u60a3\u8005\u6709\u4f4f\u9662\u72b6\u6001\u3001\u60a3\u8005\u60a3\u6709COVID-19\u3001\u60a3\u8005\u75c7\u72b6\u4e25\u91cd\u3002\u800c\u5bf9\u4e8eMCVT\u3001\u6709\u6297\u51dd\u7edd\u5bf9\u6216\u76f8\u5bf9\u7981\u5fcc\u7684IDDVT\u60a3\u8005\u66f4\u503e\u5411\u9009\u62e9\u8d85\u58f0\u968f\u8bbf\u3002\u6307\u5357\u4e2d\u5bf9\u4e8eIDDVT\u60a3\u8005\u63a8\u8350\u6297\u51dd\u6cbb\u7597\u81f3\u5c113\u4e2a\u6708\uff0c\u65e0\u9700\u6839\u636e\u8840\u6813\u5f62\u6210\u7684\u808c\u8089\u6216\u5c0f\u817f\u6df1\u9759\u8109\u4f4d\u7f6e\u8c03\u6574\u6cbb\u7597\uff0c\u5bf9\u4e8e\u764c\u75c7\u76f8\u5173\u8840\u6813\u5f62\u6210\u5efa\u8bae\u7ed9\u4e88\u8d85\u8fc73\u4e2a\u6708\u7684\u6297\u51dd\uff0c\u4f46\u76ee\u524d\u5c1a\u7f3a\u4e4f\u9488\u5bf9\u4e0d\u540c\u764c\u79cd\u53ca\u764c\u75c7\u6cbb\u7597\u9636\u6bb5\u7684\u9488\u5bf9\u6027\u6cbb\u7597\u5efa\u8bae\u3002<\/p>\n
2021\u5e74\u6b27\u6d32\u8840\u7ba1\u5916\u79d1\u5b66\u4f1a(ESVS)\u6307\u5357[8]:\u5bf9\u4e8e\u786e\u8bcaMCVT\u7684\u60a3\u8005\uff0c\u6709\u75c7\u72b6\u4f46\u672a\u5408\u5e76\u80bf\u7624\u75c5\u53f2\uff0c\u6297\u51dd\u6cbb\u7597\u9700\u8fbe3\u4e2a\u6708;\u82e5\u5408\u5e76\u80bf\u7624\u75c5\u53f2\u5219\u6297\u51dd\u6cbb\u7597\u9700\u8d85\u8fc73\u4e2a\u6708\u3002\u5bf9\u4e8e\u6709\u75c7\u72b6\u7684MCVT\u60a3\u8005\uff0c\u82e5\u672a\u63a5\u53d7\u6297\u51dd\u6cbb\u7597\uff0c\u5efa\u8bae\u884c\u4e34\u5e8a\u91cd\u65b0\u8bc4\u4f30\uff0c\u5e76\u4e8e1\u5468\u540e\u590d\u67e5\u5168\u4e0b\u80a2\u9759\u8109\u8d85\u58f0\u3002<\/p>\n
2021\u5e74\u6b27\u6d32\u5fc3\u810f\u75c5\u5b66\u4f1a\u4e13\u5bb6\u5171\u8bc6\u5efa\u8bae\uff3b9\uff3d\uff0c\u5bf9\u9ad8\u98ce\u9669\u7684IDDVT\u60a3\u8005\uff0c\u5efa\u8bae\u5168\u5242\u91cf\u6297\u51dd\u6cbb\u7597\u81f3\u5c113\u4e2a\u6708\uff0c\u5bf9\u4f4e\u98ce\u9669\u7684\u60a3\u8005\u7ed9\u4e884\uff5e6\u4e2a\u5468\u7684\u5c0f\u5242\u91cf\u4f4e\u5206\u5b50\u809d\u7d20\u6297\u51dd\u6cbb\u7597\u6216\u8d85\u58f0\u968f\u8bbf\u662f\u5b89\u5168\u6709\u6548\u7684\u3002<\/p>\n
2021\u4e2d\u56fd\u8840\u7ba1\u5916\u79d1\u4e13\u5bb6\u5236\u5b9a\u7684\u300a\u5b64\u7acb\u6027\u8fdc\u7aef\u6df1\u9759\u8109\u8840\u6813\u8bca\u7597\u5efa\u8bae\u300b\uff3b10\uff3d\uff0c\u63d0\u51fa\u5bf9\u4e8e\u53cd\u590d\u68c0\u67e5\u9759\u8109\u591a\u666e\u52d2\u8d85\u58f0\u8bc1\u5b9e\u5b58\u5728IDDVT\uff0c\u4f46\u662f\u60a3\u8005\u6ca1\u6709\u75c7\u72b6\uff0c\u52a8\u6001\u76d1\u6d4b\uff08\u5efa\u8bae\u6bcf2\u5468\u4e00\u6b21\uff0c\u7ef4\u63016\u5468\uff09D-\u4e8c\u805a\u4f53\u5448\u73b0\u9634\u6027\uff0c\u5e94\u8003\u8651\u4e3a\u9648\u65e7\u6027IDDVT\u3002\u6025\u6027\uff08\u51fa\u73b0\u4e34\u5e8a\u75c7\u72b6\u6216\u8005\u4f53\u5f812\u5468\u4ee5\u5185\uff09IDDVT\u60a3\u8005\u5728\u8bc4\u4f30\u51fa\u8840\u98ce\u9669\u8f83\u4f4e\uff08\u89c1\u4e0b\u8868\uff09\u65f6\u5e94\u5f53\u63a5\u53d7\u6297\u51dd\u6cbb\u7597\uff0c\u672a\u5408\u5e76\u6301\u7eed\u6027VTE\u8fdb\u5c55\u56e0\u7d20\u7684\u60a3\u8005\uff0c\u5efa\u8bae3\u4e2a\u6708\u6297\u51dd\u6cbb\u7597\uff0c\u5bf9\u4e8e\u6709\u8840\u6813\u8fdb\u5c55\u56e0\u7d20\u7684\uff08\u5982\u6d3b\u52a8\u671f\u80bf\u7624\u3001\u957f\u671f\u5367\u5e8a\u3001\u5408\u5e76\u6297\u78f7\u8102\u6297\u4f53\u7efc\u5408\u5f81\u3001\u86cb\u767dS\u3001\u86cb\u767dC\u7f3a\u4e4f\u6216\u8005\u5176\u4ed6\u6613\u6813\u75c7\u3001VTE\u5bb6\u65cf\u53f2\u7b49\uff09\u60a3\u8005\u53ef\u4ee5\u9002\u5f53\u5ef6\u957f\u6297\u51dd\u6cbb\u7597\u65f6\u95f4\u3002<\/p>\n
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2019\u5e74\u6fb3\u5927\u5229\u4e9a\u548c\u65b0\u897f\u5170\u8840\u6813\u5f62\u6210\u548c\u6b62\u8840\u534f\u4f1a\u6307\u5357\u5efa\u8bae[11]\uff0c\u5bf9\u4e8e\u5df2\u53bb\u9664\u5371\u9669\u56e0\u7d20\u7684IDDVT\u60a3\u8005\uff0c\u9700\u4f7f\u7528\u53e3\u670d\u6297\u51dd\u836f\u6cbb\u75976\u5468;\u800c\u5bf9\u4e8e\u5371\u9669\u56e0\u7d20\u6301\u7eed\u5b58\u5728\u7684\u60a3\u8005\uff0c\u9700\u5ef6\u957f\u6297\u51dd\u7597\u7a0b\u8fbe\u52303\u4e2a\u6708\u3002<\/p>\n
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\u53c2\u8003\u6587\u732e<\/p>\n
[1]ESSIEN E O\uff0c\uff32ALI P\uff0cMATHAI S C\uff0e Pulmonary embolism\uff3bJ\uff3d\uff0eMed Clin North Am\uff0c2019\uff0c103( 3) : 549 \uff0d564 [2]EXPE\uff32T PANEL ON VASCULA\uff32 IMAGING\uff0cBENNETT S J\uff0cDILL K E\uff0cet al\uff0e AC\uff32 appropriateness criteria\u00ae suspected thoracic aortic aneurysm\uff3bJ\uff3d\uff0e J Am Coll \uff32adiol\uff0c2018\uff0c15( 5S) : S208 \uff0d S214 [3]ZHAO W G\uff0cYAN J Y\uff0cLI X L\uff0cet al\uff0e Characteristics and treatment strategy of isolated calf deep venous thrombosis after fractures: a review of recent literature\uff3bJ\uff3d\uff0e Orthop Surg\uff0c2022\uff0c14( 7) : 1263 \uff0d 1270\uff0e [4]\u5218\u5b81. \u5c0f\u817f\u808c\u95f4\u9759\u8109\u8840\u6813\u662f\u5426\u9700\u8981\u6297\u51dd\u6cbb\u7597\u7684\u4e34\u5e8a\u7814\u7a76[D].\u6cb3\u5317\u533b\u79d1\u5927\u5b66,2019 [5]\u848b\u521d\u7281.\u4ece98\u4f8b\u5b64\u7acb\u6027\u4e0b\u80a2\u808c\u95f4\u9759\u8109\u8840\u6813\u4f1a\u8bca\u770b\u5f53\u524dVTE\u9632\u6cbb\u5de5\u4f5c\u4e2d\u7684\u4e34\u5e8a\u8bef\u533a[D].\u91cd\u5e86\u533b\u79d1\u5927\u5b66,2018. [6]\u9648\u7490,\u5f90\u78ca.\u5c0f\u817f\u808c\u95f4\u9759\u8109\u8840\u6813\u5f62\u6210\u4e0e\u80ba\u6813\u585e\u76f8\u5173\u6027\u7814\u7a76\u8fdb\u5c55[J].\u5b9e\u7528\u4e34\u5e8a\u533b\u836f\u6742\u5fd7,2023,27(12):141-148. [7]STEVENS S M\uff0cWOLLE\uff32 S C\uff0cK\uff32EUZIGE\uff32 L B\uff0cet al\uff0eAntithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report\uff3bJ\uff3d\uff0e Chest\uff0c2021\uff0c160( 6) : e545 \uff0d e608 [8]KAKKOS S K\uff0cGOHEL M\uff0cBAEKGAA\uff32D N\uff0cet al\uff0e Editor’s choice-European society for vascular surgery ( ESVS ) 2021 clinical practice guidelines on the management of venous thrombosis\uff3bJ\uff3d\uff0e Eur J Vasc Endovasc Surg\uff0c2021\uff0c61( 1) : 9 \uff0d 82\uff0e [9]MAZZOLAI L\uff0cAGENO W\uff0cALAT\uff32I A\uff0cet al\uff0e Second consensus document on diagnosis and management of acute deep vein thrombosis: updated document elaborated by the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function\uff3bJ\uff3d\uff0e Eur J Prev Cardiol\uff0c2022\uff0c29( 8) :1248 \uff0d 1263\uff0e [10]WEI\uff0cFENG\uff0e \uff32ANKL-independent modulation of osteoclastogenesis\uff3bJ\uff3d\uff0e J Oral Biosci\uff0c2019\uff0c61( 1) : 16 \uff0d 21\uff0e [11]T\uff32AN H A\uff0cGIBBS H\uff0cME\uff32\uff32IMAN E\uff0cet al\uff0e New guidelines from the Thrombosis and Haemostasis Society of Australia and New Zealand for the diagnosis and management of venous thromboembolism\uff3bJ\uff3d\uff0eMed J Aust\uff0c2019\uff0c210 ( 5) : 227\uff0d235\uff0e [12]Douketis J D, Spyropoulos A C, Murad M H, et al. Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline[J]. Chest, 2022, 162(5): e207-e243.<\/p>\n","protected":false},"excerpt":{"rendered":"
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