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JACC:冠心病伴室颤性心脏骤停怎么治疗?

2017-08-23 MedSci MedSci原创

目前,冠心病患者的院外难治性室颤(VF)或室性心动过速性(VT)猝死的流行病学资料尚缺乏。本研究纳入了2015年12月1日至2016年12月1日因难治性院外VF或VT猝死而需要心肺复苏由急诊转诊至心导管实验室(CCL)的病人,这些病人接受了体外生命支持治疗、冠脉造影术和经皮导管冠脉介入治疗。并对这些患者出院时的功能情况进行了评估比较。在72例转诊病人中,有62例(86%)病人符合急诊转诊的标准,其

目前,冠心病患者的院外难治性室颤(VF)或室性心动过速性(VT)心脏骤停的流行病学资料尚缺乏。本研究纳入了2015年12月1日至2016年12月1日因难治性院外VF或VT心脏骤停而需要心肺复苏由急诊转诊至心导管实验室(CCL)的病人,这些病人接受了体外生命支持治疗、冠脉造影术和经皮导管冠脉介入治疗。并对这些患者出院时的功能情况进行了评估比较。在72例转诊病人中,有62例(86%)病人符合急诊转诊的标准,其中有55例(88%)患者在转诊至CCL时符合继续复苏的指征,5例自主恢复循环,50例接受了体外生命支持治疗,55例患者全部进行了冠脉造影术。造影结果显示,在55例患者中,有46例(84%)患者有明显的冠脉综合征,35例(64%)患有急性血栓性病变,46例(84%)患者接受了经皮导管冠脉介入治疗,平均每个患者置入了2.7 ± 2.0个支架。所有患者的SYNTAX评分平均是29.4 ± 13.9,62例转诊的患者中,有26例(42%)患者出院时存活,比以往的存活率(15.3%)要明显提高(OR: 4.0; 95% Cl: 2.08 -7.7; p < 0.0001)。研究结果表明,难

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  1. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Thu Aug 24 09:29:12 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236467, encodeId=3b9923646ede, content=难治性室颤或室性心动过速性心脏骤停患者的冠心病患病率较高.经过系统地体外生命支持治疗和再灌注治疗可以明显提高患者生存率., beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed Aug 23 22:29:08 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236421, encodeId=c7af236421cb, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., 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    2018-07-01 hbwxf
  2. 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encryptionId=af2646250e1, topicName=室颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2500074, createdName=124987e8m07暂无昵称, createdTime=Fri Aug 25 06:57:00 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236661, encodeId=e056236661af, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 24 12:37:18 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236616, encodeId=ac472366165d, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Thu Aug 24 09:29:12 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236467, encodeId=3b9923646ede, content=难治性室颤或室性心动过速性心脏骤停患者的冠心病患病率较高.经过系统地体外生命支持治疗和再灌注治疗可以明显提高患者生存率., beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Wed Aug 23 22:29:08 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236421, encodeId=c7af236421cb, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, 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    2017-08-29 微笑着生活

    可以应用于临床.以往只是急性冠脉综合征患者才想着行冠脉介入手段治疗.房颤并没有想过要给予冠脉介入治疗.非常好的文章!

    0

  3. 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encryptionId=af2646250e1, topicName=室颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2500074, createdName=124987e8m07暂无昵称, createdTime=Fri Aug 25 06:57:00 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236661, encodeId=e056236661af, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 24 12:37:18 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236616, encodeId=ac472366165d, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., 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  4. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Aug 23 16:38:22 CST 2017, time=2017-08-23, status=1, ipAttribution=)]
    2017-08-24 龙胆草

    学习谢谢分享

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., 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    2017-08-24 lietome15

    认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦

    0

  7. 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encryptionId=af2646250e1, topicName=室颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2500074, createdName=124987e8m07暂无昵称, createdTime=Fri Aug 25 06:57:00 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236661, encodeId=e056236661af, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 24 12:37:18 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236616, encodeId=ac472366165d, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Aug 23 16:38:22 CST 2017, time=2017-08-23, status=1, ipAttribution=)]
    2017-08-23 有备才能无患

    难治性室颤或室性心动过速性心脏骤停患者的冠心病患病率较高.经过系统地体外生命支持治疗和再灌注治疗可以明显提高患者生存率.

    0

  8. 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encryptionId=af2646250e1, topicName=室颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2500074, createdName=124987e8m07暂无昵称, createdTime=Fri Aug 25 06:57:00 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236661, encodeId=e056236661af, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 24 12:37:18 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236616, encodeId=ac472366165d, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Aug 23 16:38:22 CST 2017, time=2017-08-23, status=1, ipAttribution=)]
    2017-08-23 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 23 18:00:18 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236402, encodeId=c1cd23640259, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Aug 23 16:44:06 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236399, encodeId=e54623639911, content=学了.........., beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Aug 23 16:38:22 CST 2017, time=2017-08-23, status=1, ipAttribution=)]
    2017-08-23 半夏微凉

    学习了谢谢分享

    0

  10. 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    2017-08-23 135****7952平儿

    学了..........

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