急性肺栓塞是一种起病急、进展快,甚至可能危及生命的肺部急症,但很多人对它知之甚少。 日前,山东第一医科大学第一附属医院(山东省千佛山医院)呼吸与危重症医学科副主任、三病区主任王光 海做客《壹点问医》,从发病原因、症状识别、规范治疗等方面,为大家详细解读了肺栓塞这种疾病。 记者 秦聪聪 济南报道 急性肺栓塞发病率攀升 高危人群需注意 王光海介绍,从临床数据来看,急性肺栓塞发病率正呈逐年上升趋势。在全球范围内,肺血栓栓塞症年发病 率为11.7/10万～131.9/10万,而我国住院患者的发病率从2007年的1.2/10万,一路上升至2021年的14.2/10万, 绝对患病人数已超过20万。这一数据的变化,既反映出疾病诊断水平的提升,也显示肺栓塞的防控已成为 公共卫生领域的重要课题。 此外,住院和手术患者、恶性肿瘤患者、心脑血管疾病及慢阻肺患者、肾病综合征患者、肥胖人群、吸 烟者,以及长途飞行久坐不动的人,都是肺栓塞的高发人群。 症状缺乏特异性 遇到警示信号别忽视 "急性肺栓塞的一大诊疗难点,在于其临床表现缺乏特异性,极易被漏诊、误诊。患者的症状轻重不一,从 毫无症状到突发心源性休克、猝死,都有可能出现。"王光海说 ...

Core Points - The article discusses the issue of blood viscosity, its causes, symptoms, and preventive measures against high blood viscosity, which can lead to serious health problems like heart attacks and strokes [3][8]. Group 1: Understanding Blood Viscosity - Blood viscosity refers to the "thickness" and "flowability" of blood, which increases due to a higher concentration of formed elements, leading to increased blood flow resistance and slower blood flow [3][5]. - Factors contributing to increased blood viscosity include the deformation and aggregation of red blood cells, increased platelet count, elevated levels of certain proteins in plasma, high blood lipids (especially cholesterol and triglycerides), and dehydration [5][7]. Group 2: Health Risks Associated with High Blood Viscosity - Increased blood viscosity primarily affects capillaries, obstructing oxygen and nutrient delivery, which can lead to ischemia and hypoxia in tissues [7]. - High viscosity can exacerbate friction against blood vessel walls, accelerating aging and damage to the vascular endothelium, potentially leading to atherosclerosis and thrombosis [7][8]. Group 3: Symptoms Indicating High Blood Viscosity - Five key symptoms that may indicate high blood viscosity include: 1. Dizziness upon waking, due to reduced blood flow and oxygen to the brain [10][11]. 2. Increased drowsiness after meals, particularly in individuals with vascular issues [13]. 3. Chest tightness when squatting, often seen in obese individuals [13]. 4. Cyanosis of lips after mild exertion, indicating potential hypoxia [13]. 5. Intermittent blurred vision, resulting from reduced blood flow to the retina [13][14]. Group 4: Preventive Measures - To prevent or reduce blood viscosity, the following measures are recommended: 1. Stay hydrated by drinking approximately 200 milliliters of warm water at key times throughout the day [16][17]. 2. Avoid smoking and excessive alcohol consumption, as these can damage blood vessels and increase blood viscosity [19]. 3. Maintain a balanced diet, reducing intake of cholesterol-rich foods and sugars while increasing vegetables, fruits, and whole grains [20]. 4. Engage in regular physical activity to promote circulation and manage weight [21]. 5. Manage stress and ensure adequate sleep to prevent emotional factors from contributing to high blood viscosity [22].

Core Points - Thrombosis is a special structure of blood clots formed when blood coagulates in a flowing state within blood vessels [3] - Thrombotic diseases are systemic and can affect multiple organ systems, categorized mainly by the site of formation [3] Group 1 - The three main factors for thrombosis formation include damage to blood vessel walls, slow blood flow due to prolonged sitting or lying down, and a hypercoagulable state of blood caused by medications, hormones, cancer, smoking, and obesity [5] - Thrombotic diseases can be life-threatening, and immediate medical attention is necessary if thrombosis is suspected [7] Group 2 - If not treated properly, thrombosis can worsen and spread, potentially leading to serious conditions such as deep vein thrombosis or pulmonary embolism, which can result in disability or death [9] - Prevention of thrombosis is crucial, with recommendations to consume fresh fruits and vegetables, limit meat and fat intake, and maintain regular exercise and hydration [9] Group 3 - The key to preventing thrombosis is to stay active, especially during prolonged periods of sitting or standing, with suggestions to move every 30 to 60 minutes and engage in lower limb exercises to promote blood flow [11] - Daily water intake is recommended to be between 1500 to 2000 milliliters [11]

Core Viewpoint - The articles highlight the significance of thrombosis, its formation, types, and the importance of prevention and early detection, especially in high-risk populations [1][3][9]. Group 1: Types of Thrombosis - Thrombosis is categorized into three main types: venous thrombosis, arterial thrombosis, and capillary thrombosis [1]. - Venous thrombosis includes deep vein thrombosis (DVT) and pulmonary embolism (PE), while arterial thrombosis encompasses acute coronary syndrome, atrial fibrillation, arterial ischemia, and stroke [1][6]. - DVT accounts for approximately 80% of venous thrombosis cases, making it the most prevalent form [6]. Group 2: Risk Factors and Formation - The formation of thrombosis is influenced by three key factors: damage to blood vessel walls, slow blood flow, and a hypercoagulable state of blood [3][4]. - High-risk groups include individuals over 60 years old, those with hypertension, diabetes, obesity, and those who experience prolonged immobility [6][10]. - Specific conditions such as prolonged sitting, especially in activities like playing mahjong or long flights, significantly increase the risk of DVT [6][10]. Group 3: Symptoms and Detection - Symptoms of DVT include swelling, pain, tenderness, redness, and skin changes in the affected limb [6][8]. - Two simple methods for self-assessment of DVT risk include measuring leg circumference and checking for tenderness in the calf [8]. Group 4: Prevention and Treatment - Preventive measures include regular movement, hydration, and a diet rich in fruits and vegetables while limiting meat and fats [4][11]. - Treatment options for PE include the placement of an interception device to prevent blood clots from reaching the lungs and minimally invasive techniques to dissolve clots [11].

Group 1 - Excessive salt and sugar intake can lead to high blood pressure and arterial damage, increasing the risk of heart failure and cardiovascular diseases [1][2] - High-fat, high-cholesterol, and trans fat foods also pose significant risks to vascular health and should be minimized [2] - Sedentary lifestyles, characterized by prolonged sitting, can lead to heart strain, increased blood viscosity, and a higher risk of heart disease, with an increased risk of 47% for those sitting over 8 hours a day [3] Group 2 - Lack of physical activity can cause blood flow stagnation, leading to potential blood clots and increased risk of pulmonary embolism [3] - Chronic stress and sleep deprivation can result in elevated heart rates and blood pressure, contributing to cardiovascular issues, with studies indicating that three consecutive nights of poor sleep can age blood vessels by 10 years [4][5] - The accumulation of cholesterol and triglycerides due to stress and lack of sleep can lead to arterial hardening, increasing the risk of heart disease [4][5]