摘要急性肺血栓栓塞症（PTE）是高致死率疾病，纤溶治疗能够快速改善肺部血流动力学，是挽救生命的重要治疗手段。如何筛选可从溶栓治疗中获益的患者以及降低大出血并发症仍是PTE治疗中的焦点问题，此外随着对PE后综合征（PPES）认识的不断深入，溶栓治疗在预防PPES产生方面是否具有优势也备受关注。本文拟就近几年来早期危险分层及预后评估、早期大出血风险评估、降低溶栓药物剂量、介入溶栓和PTE溶栓的长期预后等方面的研究进展进行综述。

abstractsAcute pulmonary thromboembolism (PTE) is a highly fatal disease. Fibrinolytic therapy can rapidly improve pulmonary hemodynamics and is an important life-saving treatment. How to screen patients who may benefit from thrombolytic therapy and how to reduce the complications of major bleeding are still the focus of PTE treatment. In addition, as our understanding of post-PE syndrome (PPES) has improved, much attention has been paid to whether thrombolytic therapy has any benefit in preventing PPES. This article reviewed the research progress of early risk stratification and prognosis assessment, early major bleeding risk assessment, thrombolytic drug dose reduction, interventional thrombolysis and the long-term prognosis of PTE thrombolysis in recent years.