慢性血栓栓塞性肺高壓的診斷與治療

Chronic Thromboembolic Pulmonary Hypertension: Diagnosis and Treatment

吳書豪(Shu-Hao Wu) ； 吳懿哲(Yih-Jer Wu)

《內科學誌》 28卷3期 (2017/06) Pp. 140-147

https://doi.org/10.6314/JIMT.2017.28(3).04

摘要

慢性血栓栓塞性肺高壓是一種可能被治癒的肺高壓疾病。現今，我們有各種的影像工具來幫助我們確立診斷與協助治療，如肺部灌流/ 通氣掃描、電腦斷層、核磁共振、侵入性血管攝影、或以結合多種工具的方式來進行等。肺動脈內膜切除術目前為治療的首選。然而針對無法開刀、持續或復發肺高壓的病人，可以考慮接受有限度的肺動脈氣球血管成形術。其他藥物的治療及復健也是相當重要的。

關鍵字

慢性血栓栓塞性肺高壓(Chronic thromboembolic pulmonary hypertension, CTEPH) ； 肺動脈內膜切除術(Pulmonary endarterectomy, PEA) ； 肺動脈氣球血管成形術(Balloon pulmonary angioplasty, BPA)

並列摘要

Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable causes of pulmonary hypertension. Nowadays, we have various imaging modalities to be helpful for not only diagnosis but also procedure guidance. They include ventilation-perfusion scan, computed tomography, magnetic resonance imaging, invasive angiography, or combination ones. Pulmonary endarterectomy was recommended as class I indication by guidelines. For patients with inoperable/persistent/recurrent CTEPH, a careful approach with ＂refined＂ balloon pulmonary angioplasty was proposed to reduce complications. In addition, medication and rehabilitation are also important.