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GW-ICC 2016:ACS 抗栓出血应对策略

2016-10-17 郭雪梅 《今日快讯》2016年10月16日08版

抗栓是急性冠脉综合征(ACS)药物治疗的基石。然而抗栓相关出血并发症日渐突出。“第一直播间”请到《急性冠状动脉综合征抗栓治疗合并出血防治多学科专家共识》(下称“共识”)发起人之一北京安贞医院急诊危重症中心聂绍平教授及核心专家北京协和医院沈珠军教授和北京安贞医院消化内科张杰教授,共同探讨此类患者的应对策略。聂绍平教授说,出血并发症已成为阻碍ACS患者抗栓治疗获益的“拦路虎”,而ACS抗栓合并出血的处

抗栓是急性冠脉综合征(ACS)药物治疗的基石。然而抗栓相关出血并发症日渐突出。“第一直播间”请到《急性冠状动脉综合征抗栓治疗合并出血防治多学科专家共识》(下称“共识”)发起人之一北京安贞医院急诊危重症中心聂绍平教授及核心专家北京协和医院沈珠军教授和北京安贞医院消化内科张杰教授,共同探讨此类患者的应对策略。

聂绍平教授说,出血并发症已成为阻碍ACS患者抗栓治疗获益的“拦路虎”,而ACS抗栓合并出血的处理措施却十分有限且面临诸多挑战,如治疗出血与缺血风险相互矛盾;出血常涉及不同部位需多学科协作;缺乏明确指南或专家共识。基于此,韩雅玲院士、张澍田院长和他共同发起组织编写了本“共识”,期待其发表能为临床医生提供有益、可借鉴的参考与指导。

张杰教授说,抗栓治疗是“双刃剑”,在减少心血管不良事件同时增加出血风险。患者发生出血时可根据BRAC评分确定出血等级,判断是否需要调整抗栓策略。张教授还对合并消化道出血患者的内镜及药物治疗策略作了介绍。

沈珠军教授说,抗栓合并出血时应采取全面预防策略:
①对患者行全面评估,了解详细病史;
②规范用药;
③经桡动脉途径或可减少穿刺相关出血;
④药物预防,如质子泵抑制剂(PPI)。

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    2016-10-19 zhaojie88
  3. [GetPortalCommentsPageByObjectIdResponse(id=1992246, encodeId=046d19922464c, content=<a href='/topic/show?id=7e5a492636a' target=_blank style='color:#2F92EE;'>#应对策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49263, encryptionId=7e5a492636a, topicName=应对策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jul 21 07:32:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279135, encodeId=606812e913599, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462013, encodeId=9ddc1462013b7, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36506466438, createdName=zhs3884, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527174, encodeId=7e04152e1740e, content=<a href='/topic/show?id=81ca834123' target=_blank style='color:#2F92EE;'>#GW-ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8341, encryptionId=81ca834123, topicName=GW-ICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00e511815854, createdName=chenwq12, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149345, encodeId=898214934537, content=学习了,PPI可以用于抗栓合并出血的预防,从文中得到的是这个信息吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87421705485, createdName=1de8ed50m80(暂无匿称), createdTime=Tue Oct 18 00:40:42 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149040, encodeId=7bd1149040e8, content=抗栓是关键, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Mon Oct 17 15:17:42 CST 2016, time=2016-10-17, status=1, ipAttribution=)]
    2016-10-19 zhs3884
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    2016-10-19 chenwq12
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    2016-10-18 1de8ed50m80(暂无匿称)

    学习了,PPI可以用于抗栓合并出血的预防,从文中得到的是这个信息吗?

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1992246, encodeId=046d19922464c, content=<a href='/topic/show?id=7e5a492636a' target=_blank style='color:#2F92EE;'>#应对策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49263, encryptionId=7e5a492636a, topicName=应对策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Jul 21 07:32:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279135, encodeId=606812e913599, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462013, encodeId=9ddc1462013b7, content=<a href='/topic/show?id=32fd933505' target=_blank style='color:#2F92EE;'>#ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9335, encryptionId=32fd933505, topicName=ICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36506466438, createdName=zhs3884, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527174, encodeId=7e04152e1740e, content=<a href='/topic/show?id=81ca834123' target=_blank style='color:#2F92EE;'>#GW-ICC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8341, encryptionId=81ca834123, topicName=GW-ICC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00e511815854, createdName=chenwq12, createdTime=Wed Oct 19 05:32:00 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149345, encodeId=898214934537, content=学习了,PPI可以用于抗栓合并出血的预防,从文中得到的是这个信息吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87421705485, createdName=1de8ed50m80(暂无匿称), createdTime=Tue Oct 18 00:40:42 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149040, encodeId=7bd1149040e8, content=抗栓是关键, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Mon Oct 17 15:17:42 CST 2016, time=2016-10-17, status=1, ipAttribution=)]
    2016-10-17 医路开来

    抗栓是关键

    0

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