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分级诊疗之导管主动脉瓣置换术后心脏康复

2018-09-30 弭守玲 中华医学信息导报

主动脉瓣狭窄(AS)是常见的心脏瓣膜病,随着我国人口老龄化的加剧,AS的发病率越来越高,严重威胁着我国居民的健康。众多高龄患者心功能较差以及合并其他疾病而无法进行外科手术。目前国际上已将经导管主动脉瓣置换术(TAVR)作为心外科瓣膜置换术高危或有禁忌证的重度主动脉瓣狭窄患者的首选治疗方式。TAVR是一种微创瓣膜置换手术,是指将组装好的主动脉瓣经导管置入到主动脉根部,替代原有主动脉瓣,在功能上完成主

主动脉瓣狭窄(AS)是常见的心脏瓣膜病,随着我国人口老龄化的加剧,AS的发病率越来越高,严重威胁着我国居民的健康。众多高龄患者心功能较差以及合并其他疾病而无法进行外科手术。目前国际上已将经导管主动脉瓣置换术(TAVR)作为心外科瓣膜置换术高危或有禁忌证的重度主动脉瓣狭窄患者的首选治疗方式。TAVR是一种微创瓣膜置换手术,是指将组装好的主动脉瓣经导管置入到主动脉根部,替代原有主动脉瓣,在功能上完成主动脉瓣的置换。

2010年,复旦大学附属中山医院葛均波院士完成了中国首例TAVR,之后TAVR在国内得到迅速发展。TAVR术后患者的心脏康复也日益受到重视。TAVR 术后患者有以下特点:老年患者多,合并症多;体弱;常有焦虑、抑郁情绪障碍;病情重,依从性差。TAVR术后心脏康复分为Ⅰ期(院内康复)、Ⅱ期(门诊康复)和Ⅲ期(居家康复)。患者TAVR术后接受心脏康复治疗不但是安全的,而且能显着改善患者的运动能力,生活自理能力和虚弱等整体状况,且无主要并发症发生。

2017年12月11日,复旦大学附属中山医院与徐汇区、闵行区、金山区等区域的20家协作单位成立心脏康复专科医联体,为Hospital to home(H2H)心脏康复模式的实践奠定了基础。心脏康复专科医联体整合了区域内心内科及康复科医学资源,统一临床路径、治疗规范、服务管理,通过资源共享、优势互补、上下联动共同发展,充分利用同质化管理、互联网前沿技术,实现了资源共享,搭建了医院与医院之间、医院与患者之间无缝沟通与交流。通过覆盖疾病急性期、稳定期和恢复期的布局合理、结构清晰、功能明确、富有效率的全程康复医疗服务体系,使患者得到系统管理,全程关爱。

我们通过实践H2H模式, 针对TAVR术后患者进行从医院到家庭的全程康复。具体流程: 在患者住院期间,进行心脏康复宣教,TAVR术前、术后评估, 院内Ⅰ期康复,给患者出具包括药物、运动、营养、心理、戒烟等综合心脏康复方案,以便顺利过渡到Ⅱ期康复;Ⅱ期门诊康复是指患者出院后到所属的二级医院,在专业医护团队指导下执行三级医院出具的康复处方,同时在患者执行运动处方过程中监测各项生命体征,按时去三级医院进行评估,根据新的评估报告, 重新制定康复处方,回到所属的二级医院执行。康复疗程结束, 病情稳定后进入Ⅲ期康复;Ⅲ期康复即居家康复,由家庭医师继续执行上级医院的康复处方。患者在家中康复时,佩戴远程监测设备,家庭医师通过远程对患者进行居家管理。如患者发生病情变化,及时向上级医院转诊。在TAVR术前、术后、出院前、门诊随访、居家康复期间通过监测心脏功能、运动耐量、自理能力、生命质量、焦虑和抑郁状态、营养情况、衰弱指数等指标对患者的康复效果进行评价。

H2H心脏康复模式使患者从医院到家庭顺利、平稳过渡, 促进了患者的康复。心脏康复专科医联体全力围绕“以患者为中心”的服务宗旨,使患者全程得到呵护,有助于H2H心脏康复模式落地执行,使患者真正从心脏康复中获益。

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    2019-07-29 yxch48
  2. 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    2018-12-07 jyzxjiangqin

    分级诊疗之导管主动脉瓣。

    0

  3. 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415379, encodeId=ae1614153e905, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576643, encodeId=9cfb15e664389, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-11-23 jyzxjiangqin

    分级诊疗之导管主动脉瓣疾病治疗。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1742525, encodeId=c2761e425255c, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Mon Jul 29 09:23:00 CST 2019, time=2019-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354759, encodeId=2551354e59fa, content=分级诊疗之导管主动脉瓣。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Dec 07 17:48:15 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07:53:39 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349556, encodeId=2c9d3495566e, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Oct 16 21:04:05 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347766, encodeId=28cf34e76652, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 03 13:30:13 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332559, encodeId=55ef133255982, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367133, encodeId=4f61136e133af, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415379, encodeId=ae1614153e905, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576643, encodeId=9cfb15e664389, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-30 jyzxjiangqin

    分级诊疗之导管主动脉瓣疾病。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1742525, encodeId=c2761e425255c, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Mon Jul 29 09:23:00 CST 2019, time=2019-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354759, encodeId=2551354e59fa, content=分级诊疗之导管主动脉瓣。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Dec 07 17:48:15 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07:53:39 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349556, encodeId=2c9d3495566e, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Oct 16 21:04:05 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347766, encodeId=28cf34e76652, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 03 13:30:13 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332559, encodeId=55ef133255982, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367133, encodeId=4f61136e133af, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415379, encodeId=ae1614153e905, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576643, encodeId=9cfb15e664389, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-16 jyzxjiangqin

    分级诊疗之导管主动脉瓣疾病。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1742525, encodeId=c2761e425255c, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Mon Jul 29 09:23:00 CST 2019, time=2019-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354759, encodeId=2551354e59fa, content=分级诊疗之导管主动脉瓣。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Dec 07 17:48:15 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07:53:39 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349556, encodeId=2c9d3495566e, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Oct 16 21:04:05 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347766, encodeId=28cf34e76652, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 03 13:30:13 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332559, encodeId=55ef133255982, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367133, encodeId=4f61136e133af, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415379, encodeId=ae1614153e905, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576643, encodeId=9cfb15e664389, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-03 jyzxjiangqin

    分级诊疗之导管主动脉瓣疾病。

    0

  7. 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07:53:39 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349556, encodeId=2c9d3495566e, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Oct 16 21:04:05 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347766, encodeId=28cf34e76652, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 03 13:30:13 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332559, encodeId=55ef133255982, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367133, encodeId=4f61136e133af, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], 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  8. 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07:53:39 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349556, encodeId=2c9d3495566e, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Oct 16 21:04:05 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347766, encodeId=28cf34e76652, content=分级诊疗之导管主动脉瓣疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 03 13:30:13 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332559, encodeId=55ef133255982, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Oct 02 13:23:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367133, encodeId=4f61136e133af, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], 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  9. 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  10. 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医共体急需解决四大问题,关乎分级诊疗成败

希望要探索建立起行之有效机制,在提升医疗的同时,让公共卫生也能得到同步提高,一定要避免按起葫芦浮起瓢的现象!

山东规定每个家庭医生团队签约数不得超2000人

日前,山东省卫生计生委出台政策,要求做实家庭医生签约服务,原则上每个团队签约居民数量不得超过2000人。

社区医生2型糖尿病管理流程与分级诊疗规范(深圳专家共识)

《社区医生2 型糖尿病管理流程与分级诊疗规范(深圳专家共识)》的制定,引用了国内外专业领域相关糖尿病指南、专家共识,以及重要循证医学研究作为参考依据,并对这些证据予以分类并赋予等级,质量可靠。该共识结合深圳市的区域特点和要求,与当地社区诊疗实践相结合,提出在深圳社区实际存在的问题以及有针对性的解决方案,内容比较具体、全面,总体具有可操作性。因此,该共识对社区医生进行2 型糖尿病管理具有较好的指导意

广东5万余家药店面临洗牌 处方外流大势已来?

面对即将施行的零售药店分级分类管理新规,行业人士不禁发问:是为了给处方外流做准备吗?在这种新的管理模式下,单体小药店是否还有活路?消费者又如何快速适应?

分级诊疗改革中,私人诊所的3大机遇!

在目前如火如荼的分级诊疗大潮中,作为扎根基层的诊所也应该有所作为,基于体制灵活,存有三大机遇。

防止大医院“跑马圈地”!卫健委下发分级诊疗新通知

对于具备条件的社会力量举办医疗机构,也可以牵头组建医联体、防止城市三级医院“跑马圈地”“虹吸效应”……卫健委印发分级诊疗制度重点工作通知,看看有哪些亮点。

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