肺血栓栓塞症的临床诊治进展

肺血栓栓塞症的临床诊治进展一、本文概述Overviewofthisarticle肺血栓栓塞症（PulmonaryThromboembolism，PTE）是一种常见且可能致命的疾病，其发病率和死亡率在全球范围内均呈上升趋势。由于PTE的临床表现多样，诊断难度较大，因此，对于其临床诊治的研究一直是医学界的热点。本文旨在全面综述近年来肺血栓栓塞症的临床诊治进展，包括其流行病学特征、诊断方法、治疗策略以及预后评估等方面，以期为临床医师提供更为精准和有效的诊疗依据，提高PTE的诊治水平，降低其发病率和死亡率。Pulmonarythromboembolism(PTE)isacommonandpotentiallyfataldisease.Itsincidencerateandmortalityareontheriseworldwide.DuetothediverseclinicalmanifestationsandhighdiagnosticdifficultyofPTE,researchonitsclinicaldiagnosisandtreatmenthasalwaysbeenahottopicinthemedicalcommunity.Thepurposeofthisarticleistocomprehensivelyreviewtheclinicaldiagnosisandtreatmentprogressofpulmonarythromboembolisminrecentyears,includingitsepidemiologicalcharacteristics,diagnosticmethods,treatmentstrategiesandprognosisevaluation,soastoprovideclinicianswithmoreaccurateandeffectivediagnosisandtreatmentbasis,improvethediagnosisandtreatmentlevelofPTE,andreduceitsincidencerateandmortality.我们将从PTE的流行病学特征出发，探讨其发病机制和影响因素，为后续的诊断和治疗提供理论基础。接着，我们将重点介绍PTE的诊断方法，包括临床表现、实验室检查、影像学检查等，并对比各种诊断方法的优缺点，为临床医师提供实用的诊断策略。在治疗方面，我们将详细介绍目前常用的治疗策略，包括溶栓治疗、抗凝治疗、机械通气等，并分析各种治疗方法的适应症和禁忌症，以便临床医师根据患者的具体情况制定个性化的治疗方案。我们将对PTE的预后评估进行探讨，以期为患者提供更为准确的预后判断，指导其后续治疗和康复。WewillexplorethepathogenesisandinfluencingfactorsofPTEbasedonitsepidemiologicalcharacteristics,providingatheoreticalbasisforsubsequentdiagnosisandtreatment.Next,wewillfocusonintroducingthediagnosticmethodsofPTE,includingclinicalmanifestations,laboratorytests,imagingexaminations,etc.,andcomparetheadvantagesanddisadvantagesofvariousdiagnosticmethodstoprovidepracticaldiagnosticstrategiesforclinicalphysicians.Intermsoftreatment,wewillprovideadetailedintroductiontocommonlyusedtreatmentstrategies,includingthrombolytictherapy,anticoagulanttherapy,mechanicalventilation,etc.,andanalyzetheindicationsandcontraindicationsofvarioustreatmentmethods,sothatclinicalphysicianscandeveloppersonalizedtreatmentplansbasedonthespecificsituationofpatients.WewillexploretheprognosticevaluationofPTEinordertoprovidepatientswithmoreaccurateprognosticjudgmentandguidetheirsubsequenttreatmentandrehabilitation.通过本文的综述，我们期望能够为临床医师提供一份全面、系统的肺血栓栓塞症诊治指南，帮助他们在实践中更好地应对PTE的挑战，提高诊治水平，为患者带来更好的治疗效果和生活质量。Throughthisreview,wehopetoprovideclinicalphysicianswithacomprehensiveandsystematicguideforthediagnosisandtreatmentofpulmonarythromboembolism,helpingthembettercopewiththechallengesofPTEinpractice,improvethelevelofdiagnosisandtreatment,andbringbettertreatmentoutcomesandqualityoflifetopatients.二、肺血栓栓塞症的病因与发病机制Theetiologyandpathogenesisofpulmonarythromboembolism肺血栓栓塞症（PulmonaryThromboembolism，PTE）是一种由于内源性或外源性栓子堵塞肺动脉或其分支，引起肺循环障碍的临床和病理生理综合征。其病因与发病机制多种多样，深入了解这些机制对于疾病的预防、诊断和治疗具有重要意义。Pulmonarythromboembolism(PTE)isaclinicalandpathophysiologicalsyndromecausedbyendogenousorexogenousemboliblockingthepulmonaryarteryoritsbranches,leadingtopulmonarycirculatorydisorders.Theetiologyandpathogenesisofthisdiseasearediverse,andadeepunderstandingofthesemechanismsisofgreatsignificancefortheprevention,diagnosis,andtreatmentofthedisease.内源性因素：主要源自血液凝固性增高和血流速度减慢。例如，创伤、手术、长期卧床、肿瘤、妊娠、口服避孕药等因素可能导致血液高凝状态，增加血栓形成的风险。Endogenousfactors:mainlyderivedfromincreasedbloodcoagulationandslowedbloodflowvelocity.Forexample,factorssuchastrauma,surgery,long-termbedrest,tumors,pregnancy,andoralcontraceptivesmayleadtohypercoagulableblood,increasingtheriskofthrombosis.外源性因素：主要包括深静脉血栓形成（DVT）和静脉血栓脱落。深静脉血栓形成后，部分血栓可能脱落并随血流进入肺动脉，引发肺血栓栓塞症。Exogenousfactors:mainlyincludingdeepveinthrombosis(DVT)andvenousthrombusshedding.Aftertheformationofdeepveinthrombosis,somethrombimaydetachandenterthepulmonaryarterywithbloodflow,leadingtopulmonarythromboembolism.肺动脉阻塞：血栓阻塞肺动脉或其分支，导致肺循环阻力增加，肺动脉压升高，进而引起右心负荷加重，可能导致右心衰竭。Pulmonaryarteryocclusion:Thrombosisobstructsthepulmonaryarteryoritsbranches,leadingtoincreasedpulmonarycirculationresistanceandelevatedpulmonaryarterypressure,whichinturnincreasestheburdenontherightheartandmayleadtorightheartfailure.神经体液反应：肺动脉阻塞后，机体通过神经体液反应来适应这种变化，包括释放儿茶酚胺、血管紧张素等缩血管物质，导致肺动脉痉挛，进一步加重肺动脉高压。Neurohumoralresponse:Afterpulmonaryarteryocclusion,thebodyadaptstothischangethroughneurohumoralresponse,includingthereleaseofvasoconstrictingsubstancessuchascatecholaminesandangiotensin,leadingtopulmonaryarteryspasmandfurtherexacerbatingpulmonaryarterialhypertension.炎症反应：血栓阻塞肺动脉后，局部组织发生炎症反应，释放大量炎症介质，如肿瘤坏死因子（TNF）、白细胞介素（IL）等，导致肺组织损伤。Inflammatoryresponse:Afterthrombusblocksthepulmonaryartery,localtissueundergoesaninflammatoryresponse,releasingalargeamountofinflammatorymediatorssuchastumornecrosisfactor(TNF),interleukin(IL),etc.,leadingtolungtissuedamage.呼吸功能障碍：肺动脉阻塞导致肺组织灌注不足，气体交换受阻，出现低氧血症和高碳酸血症，严重时可导致呼吸衰竭。Respiratorydysfunction:Pulmonaryarteryobstructionleadstoinsufficientperfusionoflungtissue,obstructedgasexchange,hypoxemiaandhypercapnia,andinseverecases,canleadtorespiratoryfailure.肺血栓栓塞症的病因和发病机制涉及多个方面，了解这些因素有助于我们更好地认识和理解这一疾病，为临床诊断和治疗提供有力支持。Theetiologyandpathogenesisofpulmonarythromboembolisminvolvemultipleaspects.Understandingthesefactorshelpsusbetterunderstandandcomprehendthisdisease,providingstrongsupportforclinicaldiagnosisandtreatment.三、肺血栓栓塞症的临床表现与诊断Clinicalmanifestationsanddiagnosisofpulmonarythromboembolism肺血栓栓塞症（PTE）的临床表现多样，缺乏特异性，轻者可能无明显症状，重者则可能出现危及生命的休克和呼吸衰竭。最常见的症状包括呼吸困难、胸痛、咳嗽、咯血等，这些症状可能与深静脉血栓形成的体征同时存在。PTE患者还可能出现心率增快、呼吸急促、低热等全身症状。因此，对于疑似PTE的患者，临床医师需要具备高度的警惕性和识别能力。Theclinicalmanifestationsofpulmonarythromboembolism(PTE)arediverseandlackspecificity.Mildcasesmayhavenoobvioussymptoms,whileseverecasesmayleadtolife-threateningshockandrespiratoryfailure.Themostcommonsymptomsincludedifficultybreathing,chestpain,cough,hemoptysis,etc.Thesesymptomsmaycoexistwithsignsofdeepveinthrombosis.PTEpatientsmayalsoexperiencesystemicsymptomssuchasincreasedheartrate,shortnessofbreath,andlowfever.Therefore,forpatientssuspectedofPTE,clinicalphysiciansneedtohaveahighlevelofvigilanceandidentificationability.PTE的诊断需要结合患者的临床表现、实验室检查、影像学检查等多方面的信息。通过详细询问病史和体格检查，了解患者是否存在PTE的高危因素，如深静脉血栓形成、恶性肿瘤、长期卧床等。实验室检查方面，可以通过检测血浆D-二聚体、血气分析、心肌酶谱等指标，辅助判断是否存在PTE。然而，这些指标的特异性并不高，因此不能作为PTE的确诊依据。ThediagnosisofPTEneedstocombinevariousinformationsuchasthepatient'sclinicalmanifestations,laboratorytests,andimagingexaminations.Bydetailedinquiryofmedicalhistoryandphysicalexamination,understandwhetherthepatienthashigh-riskfactorsforPTE,suchasdeepveinthrombosis,malignanttumors,long-termbedrest,etc.Intermsoflaboratorytesting,plasmaD-dimer,bloodgasanalysis,myocardialenzymespectrumandotherindicatorscanbedetectedtoassistindeterminingthepresenceofPTE.However,thespecificityoftheseindicatorsisnothigh,sotheycannotbeusedasadiagnosticbasisforPTE.影像学检查在PTE的诊断中具有重要的地位。常用的影像学检查方法包括螺旋CT肺动脉造影（CTPA）、放射性核素肺通气/灌注扫描、肺动脉造影等。其中，CTPA以其无创、快速、准确性高的特点，成为目前PTE诊断的首选方法。CTPA可以直观地显示肺动脉内的血栓及其阻塞程度，对于PTE的诊断和病情评估具有重要的价值。ImagingexaminationplaysanimportantroleinthediagnosisofPTE.ThecommonlyusedimagingexaminationmethodsincludespiralCTpulmonaryangiography(CTPA),radioactivelungventilation/perfusionscanning,pulmonaryangiography,etc.Amongthem,CTPAhasbecomethepreferredmethodfordiagnosingPTEduetoitsnon-invasive,fast,andhighaccuracycharacteristics.CTPAcanvisuallydisplaythedegreeofthrombosisandobstructioninpulmonaryarteries,whichisofgreatvalueforthediagnosisandassessmentofPTE.需要注意的是，PTE的诊断过程中需要排除其他可能导致类似临床表现的疾病，如急性心肌梗死、肺炎、慢性阻塞性肺疾病等。因此，临床医师需要具备全面的临床知识和鉴别诊断能力，以确保PTE的准确诊断。ItshouldbenotedthatthediagnosticprocessofPTEneedstoexcludeotherdiseasesthatmaycausesimilarclinicalmanifestations,suchasacutemyocardialinfarction,pneumonia,chronicobstructivepulmonarydisease,etc.Therefore,clinicalphysiciansneedtohavecomprehensiveclinicalknowledgeanddifferentialdiagnosticabilitiestoensureaccuratediagnosisofPTE.PTE的临床表现多样，缺乏特异性，诊断需要结合患者的临床表现、实验室检查、影像学检查等多方面的信息。临床医师需要具备高度的警惕性和识别能力，以确保PTE的及时诊断和治疗。TheclinicalmanifestationsofPTEarediverseandlackspecificity,anddiagnosisrequiresacombinationofpatientclinicalmanifestations,laboratorytests,imagingexaminations,andotherinformation.CliniciansneedtohaveahighlevelofvigilanceandrecognitionabilitytoensuretimelydiagnosisandtreatmentofPTE.四、肺血栓栓塞症的治疗Treatmentofpulmonarythromboembolism肺血栓栓塞症（PTE）的治疗策略主要包括急性期治疗、药物治疗、机械辅助治疗以及长期抗凝治疗等。近年来，随着医学研究的深入，PTE的临床诊治进展显著，治疗方法不断创新和优化，为患者提供了更多治疗选择。Thetreatmentstrategiesforpulmonarythromboembolism(PTE)mainlyincludeacutephasetreatment,drugtherapy,mechanicaladjuvanttherapy,andlong-termanticoagulanttherapy.Inrecentyears,withthedeepeningofmedicalresearch,theclinicaldiagnosisandtreatmentofPTEhavemadesignificantprogress,andthetreatmentmethodshavebeencontinuouslyinnovatedandoptimized,providingpatientswithmoretreatmentoptions.急性期治疗：急性期治疗的主要目标是稳定患者生命体征，防止病情进一步恶化。这包括保持患者安静，监测生命体征，如呼吸、心率、血压等，以及进行必要的实验室检查，如血气分析、心电图等。同时，对于症状严重的患者，可能需要进行机械通气、循环支持等高级生命支持措施。Acutephasetreatment:Themaingoalofacutephasetreatmentistostabilizethepatient'svitalsignsandpreventfurtherdeteriorationofthecondition.Thisincludeskeepingthepatientquiet,monitoringvitalsignssuchasbreathing,heartrate,bloodpressure,etc.,andconductingnecessarylaboratorytestssuchasbloodgasanalysis,electrocardiogram,etc.Meanwhile,forpatientswithseveresymptoms,advancedlifesupportmeasuressuchasmechanicalventilationandcirculatorysupportmaybenecessary.药物治疗：药物治疗是PTE治疗的重要组成部分，主要包括抗凝治疗和溶栓治疗。抗凝治疗可以有效防止血栓形成和复发，常用的抗凝药物包括华法林、普通肝素等。溶栓治疗则通过溶解已经形成的血栓，恢复肺动脉的血流，常用的溶栓药物包括尿激酶、链激酶等。近年来，随着新型抗凝药物和溶栓药物的研发，药物治疗的效果和安全性得到了进一步提升。Drugtherapy:DrugtherapyisanimportantcomponentofPTEtreatment,mainlyincludinganticoagulanttherapyandthrombolytictherapy.Anticoagulanttherapycaneffectivelypreventthrombosisandrecurrence,andcommonlyusedanticoagulantdrugsincludewarfarin,heparin,etc.Thrombolytictherapyinvolvesdissolvingexistingbloodclotsandrestoringpulmonaryarterybloodflow.Commonlyusedthrombolyticdrugsincludeurokinase,streptokinase,etc.Inrecentyears,withthedevelopmentofnewanticoagulantsandthrombolyticdrugs,theeffectivenessandsafetyofdrugtherapyhavebeenfurtherimproved.机械辅助治疗：对于部分药物治疗效果不佳或病情严重的PTE患者，可以考虑采用机械辅助治疗。常用的机械辅助治疗方法包括经导管碎栓术、经导管抽吸血栓术以及肺动脉内支架植入术等。这些机械辅助治疗方法可以有效去除肺动脉内的血栓，恢复肺动脉的血流，提高患者的生存率和生活质量。Mechanicalassistedtherapy:ForPTEpatientswithpoordrugtreatmentefficacyorseverecondition,mechanicalassistedtherapycanbeconsidered.Thecommonlyusedmechanicalassistedtreatmentmethodsincludetranscatheterthrombectomy,transcatheterthrombectomy,andpulmonaryarterystentimplantation.Thesemechanicalassistedtreatmentmethodscaneffectivelyremovethrombusinthepulmonaryartery,restorebloodflowinthepulmonaryartery,andimprovethesurvivalrateandqualityoflifeofpatients.长期抗凝治疗：对于PTE幸存者，长期抗凝治疗是预防复发和降低死亡率的重要手段。长期抗凝治疗的选择应根据患者的具体情况进行个体化评估，包括患者的年龄、性别、基础疾病、出血风险等因素。常用的长期抗凝药物包括华法林、新型口服抗凝药物（NOACs）等。Longtermanticoagulanttherapy:ForsurvivorsofPTE,long-termanticoagulanttherapyisanimportantmeansofpreventingrecurrenceandreducingmortality.Theselectionoflong-termanticoagulanttherapyshouldbeindividualizedbasedonthespecificsituationofthepatient,includingfactorssuchasage,gender,underlyingdisease,bleedingrisk,etc.Commonlyusedlong-termanticoagulantsincludewarfarin,noveloralanticoagulants(NOACs),etc.肺血栓栓塞症的治疗需要综合考虑患者的具体情况和病情严重程度，制定个体化的治疗方案。随着医学研究的深入和新技术的发展，PTE的治疗策略将不断优化和完善，为患者提供更好的治疗效果和生活质量。Thetreatmentofpulmonarythromboembolismrequirescomprehensiveconsiderationofthepatient'sspecificsituationandseverityofthecondition,andthedevelopmentofpersonalizedtreatmentplans.Withthedeepeningofmedicalresearchandthedevelopmentofnewtechnologies,thetreatmentstrategiesforPTEwillcontinuetobeoptimizedandimproved,providingpatientswithbettertreatmentoutcomesandqualityoflife.五、肺血栓栓塞症的预防Preventionofpulmonarythromboembolism肺血栓栓塞症（PTE）是一种常见的心血管疾病，严重危害患者的健康和生命安全。因此，对PTE的预防显得尤为重要。预防PTE的策略主要围绕两个方面：一是控制和管理危险因素，二是实施有效的抗凝和抗栓治疗。Pulmonarythromboembolism(PTE)isacommoncardiovasculardiseasethatseriouslyendangersthehealthandsafetyofpatients.Therefore,thepreventionofPTEisparticularlyimportant.ThestrategyforpreventingPTEmainlyrevolvesaroundtwoaspects:first,controllingandmanagingriskfactors,andsecond,implementingeffectiveanticoagulantandantithrombotictreatments.控制和管理危险因素是预防PTE的基础。PTE的危险因素主要包括静脉血栓栓塞症（VTE）的病史、长期卧床、制动、手术、创伤、恶性肿瘤、妊娠、口服避孕药、激素替代治疗等。针对这些危险因素，我们可以通过改善生活方式、增加活动、避免长期卧床、控制慢性病、合理使用药物等方式进行预防。ControllingandmanagingriskfactorsisthefoundationforpreventingPTE.TheriskfactorsforPTEmainlyincludeahistoryofvenousthromboembolism(VTE),long-termbedrest,immobilization,surgery,trauma,malignanttumors,pregnancy,oralcontraceptives,hormonereplacementtherapy,etc.Wecanpreventtheseriskfactorsbyimprovinglifestyle,increasingactivity,avoidinglong-termbedrest,controllingchronicdiseases,andusingmedicationreasonably.抗凝和抗栓治疗是预防PTE的重要手段。对于已经存在VTE的患者，应尽早开始抗凝治疗，以防止血栓的发展和脱落。抗凝治疗可以选择华法林、低分子量肝素等抗凝药物。对于高危患者，如手术后、创伤后、长期卧床等，也应考虑预防性使用抗凝药物。新型口服抗凝药物（NOACs）如达比加群酯、利伐沙班等，因其抗凝效果稳定、使用方便，也被广泛应用于PTE的预防。AnticoagulantandantithrombotictreatmentsareimportantmeansofpreventingPTE.ForpatientswhoalreadyhaveVTE,anticoagulanttherapyshouldbestartedasearlyaspossibletopreventthedevelopmentanddetachmentofbloodclots.Anticoagulanttherapycanchooseanticoagulantdrugssuchaswarfarinandlowmolecularweightheparin.Forhigh-riskpatients,suchasaftersurgery,trauma,long-termbedrest,etc.,preventiveuseofanticoagulantsshouldalsobeconsidered.Neworalanticoagulantdrugs(NOACs)suchasdabigatranesterandrivaroxabanarewidelyusedinthepreventionofPTEduetotheirstableanticoagulanteffectsandconvenientuse.对于存在PTE高危因素的患者，还应定期进行PTE的筛查和监测。这包括定期进行血液检查、超声心动图、肺动脉造影等检查，以便及时发现并处理PTE。Forpatientswithhigh-riskfactorsforPTE,regularscreeningandmonitoringofPTEshouldalsobeconducted.Thisincludesregularbloodtests,echocardiography,pulmonaryangiography,andotherexaminationstodetectandmanagePTEinatimelymanner.预防PTE需要综合考虑患者的具体情况，制定个性化的预防策略。通过控制危险因素、实施有效的抗凝和抗栓治疗以及定期进行PTE的筛查和监测，我们可以有效降低PTE的发病率，保护患者的健康和生命安全。PreventingPTErequirescomprehensiveconsiderationofthepatient'sspecificsituationandthedevelopmentofpersonalizedpreventionstrategies.Bycontrollingriskfactors,implementingeffectiveanticoagulantandantithrombotictreatment,andconductingregularscreeningandmonitoringofPTE,wecaneffectivelyreducetheincidencerateofPTEandprotectthehealthandlifesafetyofpatients.六、肺血栓栓塞症的临床诊治进展Progressinclinicaldiagnosisandtreatmentofpulmonarythromboembolism肺血栓栓塞症（PTE）是一种常见且严重的心血管疾病，其诊断与治疗的进展对于改善患者预后具有重要意义。近年来，随着医学研究的深入，PTE的临床诊治取得了显著的进步。Pulmonarythromboembolism(PTE)isacommonandseriouscardiovasculardisease,andtheprogressofitsdiagnosisandtreatmentisofgreatsignificanceforimprovingtheprognosisofpatients.Inrecentyears,withthedeepeningofmedicalresearch,significantprogresshasbeenmadeintheclinicaldiagnosisandtreatmentofPTE.在诊断方面，多层螺旋CT肺动脉造影（CTPA）已成为PTE的首选检查方法，其高敏感度、高特异度以及无创性使得其在PTE的诊断中占据重要地位。血浆D-二聚体检测、超声心动图等辅助检查的应用，也提高了PTE的诊断准确性。同时，基因检测、炎症标志物等新型生物标志物的研究，为PTE的早期诊断提供了新的思路。Intermsofdiagnosis,multi-slicespiralCTpulmonaryangiography(CTPA)hasbecomethepreferredexaminationmethodforPTE.Itshighsensitivity,specificity,andnon-invasivenaturemakeitanimportantdiagnosticmethodforPTE.TheapplicationofauxiliaryexaminationssuchasplasmaD-dimerdetectionandechocardiographyhasalsoimprovedthediagnosticaccuracyofPTE.Atthesametime,thestudyofnewbiomarkerssuchasgenetictestingandinflammatorymarkersprovidesnewideasfortheearlydiagnosisofPTE.在治疗方面，溶栓治疗仍然是PTE的主要治疗手段之一。随着溶栓药物的更新换代，新型溶栓药物的出现使得溶栓治疗的效果更加显著，副作用也明显减少。机械通气、抗凝治疗、肺动脉血栓摘除术等综合治疗手段的应用，也极大地提高了PTE的治疗效果。Intermsoftreatment,thrombolysisremainsoneofthemaintreatmentmethodsforPTE.Withtheupdateandreplacementofthrombolyticdrugs,theemergenceofnewthrombolyticdrugshasmadetheeffectivenessofthrombolytictherapymoresignificant,andthesideeffectshavealsobeensignificantlyreduced.Theapplicationofcomprehensivetreatmentmethodssuchasmechanicalventilation,anticoagulanttherapy,andpulmonaryarterythrombectomyhasgreatlyimprovedthetherapeuticeffectofPTE.值得一提的是，随着个体化治疗和精准医疗理念的深入，PTE的诊治也越来越注重患者的个体差异和疾病特点。例如，对于高龄、合并症多等高风险患者，医生会根据患者的具体情况制定个体化的治疗方案，以提高治疗效果并降低并发症的发生率。Itisworthmentioningthatwiththedeepeningofpersonalizedtreatmentandprecisionmedicineconcepts,thediagnosisandtreatmentofPTEarealsoincreasinglyfocusingonindividualdifferencesanddiseasecharacteristicsofpatients.Forexample,forhigh-riskpatientswithadvancedageandmultiplecomorbidities,doctorswilldeveloppersonalizedtreatmentplansbasedonthepatient'sspecificsituationtoimprovetreatmenteffectivenessandreducetheincidenceofcomplications.随着医学技术的不断进步，PTE的临床诊治取得了显著的进展。未来，随着新型诊断技术和治疗方法的不断涌现，相信PTE的诊治水平将会得到进一步提升，为患者的健康和生命安全提供更加坚实的保障。Withthecontinuousadvancementofmedicaltechnology,significantprogresshasbeenmadeintheclinicaldiagnosisandtreatmentofPTE.Inthefuture,withthecontinuousemergenceofnewdiagnostictechnologiesandtreatmentmethods,itisbelievedthatthediagnosisandtreatmentlevelofPTEwillbefurtherimproved,providingamoresolidguaranteeforthehealthandlifesafetyofpatients.七、结论Conclusion肺血栓栓塞症（PTE）是一种常见且可能致命的疾病，其临床诊治的进展对于提高患者生存率和生活质量具有重要意义。随着医学科技的不断发展，我们对PTE的病理生理机制有了更深入的理解，诊断技术也日益精进，治疗手段也更加多样化。Pulmonarythromboembolism(PTE)isacommonandpotentiallyfataldisease,andtheprogressofitsclinicaldiagnosisandtreatmentisofgreatsignificanceforimprovingthesurvivalrateandqualityoflifeofpatients.Withthecontinuousdevelopmentofmedicaltechnology,wehavegainedadeeperunderstandingofthepathologicalandphysiologicalmechanismsofPTE,diagnostictechniquesarebecomingincreasinglysophisticated,andtreatmentmethodsarebecomingmorediverse.诊断方面，除了传统的临床表现、实验室检查和影像学检查外，新型的生物标志物和先进的影像技术，如CT肺动脉造影、MRI等，为PTE的早期、快速、准确诊断提供了可能。这些技术的发展使得我们能够更早地发现疾病，从而及时进行干预，提高治疗效果。Intermsofdiagnosis,inadditiontotraditionalclinicalmanifestations,laboratorytests,and