Clinical diagnosis and prognosis of pulmonary thromboembolism

Abstract


Pulmonary thromboembolism (PTE) is a nosological entity that complicates the course of many diseases. This circumstance determines difficulties in the diagnosis and determination of further patient management tactics. Bolus-enhanced computed tomography of pulmonary arteries, a method having high resolution and high accuracy, is presently accepted to be the gold standard to verify the diagnosis. At the same time this radiocontrast study cannot be used as a screening tool by economic and other reasoning, which determines the importance of the clinical diagnosis of the disease. This review considers different approaches to diagnosing PTE and a base of elaborated clinical algorithms and comparatively assesses empirical and scoring systems for the diagnosis and prediction of a disease course characterized by the rapidness and unpredictability of an outcome even in correctly made diagnosis.

Full Text

Клиническая диагностика и прогноз тромбоэмболии легочных артерий. - Аннотация. Тромбоэмболия легочных артерий (ТЭЛА) - нозологическая форма, осложняющая течение многих заболеваний. Данное обстоятельство определяет трудности диагностики и определения дальнейшей тактики ведения пациентов. "Золотым стандартом" верификации диагноза в настоящее время принята компьютерная томография с болюсным усилением легочных артерий - метод, обладающий высокой разрешающей способностью и точностью. Между тем в силу экономических и других соображений подобное рентгеноконтрастное исследование не может быть использовано в качестве скринингового, что и определяет важность клинической диагностики заболевания. В обзоре рассмотрены различные подходы к диагностике ТЭЛА и база созданных клинических алгоритмов, проведена сравнительная оценка эмпирической и балльной систем диагностики и прогноза течения заболевания, характеризующегося скоротечностью и непредсказуемостью исхода даже при верно поставленном диагнозе.

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