PODCAST. PATE?

PATE (plaučių arterijų trombinė embolija) – didžiulė šiuolaikinės medicinos problema. Staigi plaučių arterijos šakų okliuzija gali lemti ūminį, gyvybei grėsmingą, bet potencialiai grįžtamą dešiniojo skilvelio nepakankamumą.

Diagnozę nustatyti yra sunku, dalis atvejų lieka neatpažinti. Negydomų ligonių mirštamumas siekia 30 proc., bet, nustačius diagnozę ir skyrus tinkamą gydymą antikoaguliantais, jis sumažėja iki 2–8 proc.

PATE dažnu atveju yra sunkios pagrindinės ligos nulemta mirtinos baigties priežastis.

Paklausykite PODCAST apie PATE diagnostiką. Kaip? Ką? ir Kada? reikia daryti, kad išvengtume hiperdiagnostikos ir neišleistume į namus paciento kuriam pasireiškė PATE.

 

Žemiau pateiktas visų veiksmų, reikalingų PATE diagnostikai algoritmas, kuris buvo sudarytas vadovaujantis naujausiomis rekomendacijomis ir patvirtintas LSMUL KK SPS skyriuje.

PE jpg

 

VELSO Kriterijai

Balas

Buvusi giliųjų venų trombozė arba PE

1,5

Neseniai buvusi operacija ar imobilizacija (4 sav.)

1,5

Aktyvi piktybinė liga

1

Kraujo atkosėjimas

1

ŠSD >100 k./min.

1,5

Giliųjų kojų venų trombozės klinikiniai simptomai

3

Kliniškai labiausiai tikėtina PE

3

* PATE mažai tikėtina 0–4

* PATE didelė tikimybė >4

 

PERC score naudojamas,  kai nustatoma maža rizika taikant VELSO kriterijus.

 Jei atsakote nors į vieną teiginį ne –> atliekate D-dimerų tyrimą, jei į visus teiginius atsakote TAIP –> D-dimerų tyrimo atlikti nereikia.

PERC score:

  1. Amžius < 50 metų;
  2. ŠSD < 100 k/min;
  3. SpO2 > 94 proc.;
  4. Nėra vienos kojos patinimo;
  5. Neatkosti kraujo;
  6. Nebuvo operacijos 1 mėn. laikotarpiu;
  7. Nėra buvę GVT ar PE;
  8. Nevartoja hormonų per/os;

 

SM Gyd. rez. Eglė Zelbienė

Naudota literatūra:

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