专题:观点更新与解读,知识的扩容--房颤指南荟萃(内附沈法荣教授视频)

2017-03-31 MedSci MedSci原创

   房颤是一种以快速、无序心房电活动为特征的室上性快速性心律失常。心房因无序电活动而失去有效收缩,且房室结对快速心房激动呈现递减传导,造成极不规则心室律以及快速或缓慢心室率,导致心脏泵血功能下降,心房内附壁血栓形成。虽然房颤 本身是一种“良性”心律失常,不会直接引起死亡,但 房颤会显著降低患者的生存质量,并通过引起血栓、心衰等并发症间接增加死亡风险。近年来,房颤 的治疗发

   
房颤是一种以快速、无序心房电活动为特征的室上性快速性心律失常。心房因无序电活动而失去有效收缩,且房室结对快速心房激动呈现递减传导,造成极不规则心室律以及快速或缓慢心室率,导致心脏泵血功能下降,心房内附壁血栓形成。虽然房颤 本身是一种“良性”心律失常,不会直接引起死亡,但 房颤会显著降低患者的生存质量,并通过引起血栓、心衰等并发症间接增加死亡风险。近年来,房颤 的治疗发生了飞速发展,各种新兴理念应运而生。梅斯小编整理了房颤患者围手术期、手术期及管理指南,寄希望为外科医生治疗房颤提供一些帮助!
  
2017版指南敦促更多地使用手术以改善房颤患者的医疗护理。指南回顾了当前对房颤的认识,为3种临床情况提供了建议:房颤外科消融与二尖瓣手术同时进行,房颤外科消融与主动脉瓣手术或CABG同时进行,单独的房颤外科消融。指南呼吁更多的采用外科消融治疗房颤,认为这种方法有利于长期节律控制,改善患者生活质量和临床预后。
    二、2017年STS房颤外科消融治疗指南的解读

    2016年12月19日,美国胸外科医师学会(STS)发布了房颤外科消融临床实践指南,鼓励更多采用外科技术优化患者治疗。这份指南汇聚了顶尖的国际房颤外科治疗专家,包括圣路易斯华盛顿大学Damiano教授、密歇根大学Bolling教授、克利夫兰Gilllinov教授、芝加哥西北大学McCarthy教授、德克萨斯贝勒心脏中心Edgerton教授等,本文就该指南的相关要点进行了解读。首都医科大学附属北京安贞医院 张海波 孟旭
      三、
        
      2017年1月,美国心脏病学会(ACC)发布了非瓣膜性房颤患者围术期抗凝治疗的决策路径专家共识
         
      • 共识:非瓣膜性房颤患者围术期抗凝治疗的决策路径" target="_blank">2017 ACC专家共识:非瓣膜性房颤患者围术期抗凝治疗的决策路径
      • 四、房颤患者围术期如何抗凝管理?ACC发布临床决策共识
         
        长期口服抗凝治疗的房颤患者如何进行围术期管理,是非常棘手的问题,而且不同医院和医生的处理变化较大。针对这一临床难题,1月9日,美国心脏病学会(ACC)在线发表了非瓣膜性房颤患者围术期抗凝管理临床决策的专家共识文件。以下是指导推荐的要点总结。
          五、2016 ESC:欧洲房颤管理指南

          2016年8月,欧洲心脏病学会(ESC)发布了房颤管理指南,为ESC第2版房颤指南,指南涉及房颤的流行病学,病理学,诊断,分类和管理等内容。
            六、《2016年欧洲心脏病学会心房颤动管理指南》解读 

            《2016年ESC房颤指南》主要的亮点包括:(1) 房颤要早期发现,早期治疗,降低卒中的发生率。(2) 抗凝治疗方面,不推荐阿司匹林。对CHA2DS2-VASc 评分≥2 分的患者建议使用口服抗凝药物(OAC) ,优先选择新型口服抗凝药物( NOAC)。(3) 导管消融适应证更加扩宽。(4) 对房颤患者强调整体和整合的医护管理。首都医科大学附属北京朝阳医院心脏中心 杨新春

              版权声明:
              本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
              在此留言
              评论区 (6)
              #插入话题
              1. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
                2017-12-16 venlin
              2. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
              3. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
                2017-04-01 ylzr123

                不错的指南,为我们探讨研究提供了方针,给点个赞了!

                0

              4. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
                2017-03-31 Chongyang Zhang

                签到学习了很多。

                0

              5. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
                2017-03-31 流浪野医

                已经学习,谢谢分享!

                0

              6. [GetPortalCommentsPageByObjectIdResponse(id=1681336, encodeId=d070168133610, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat Dec 16 06:50:00 CST 2017, time=2017-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1707428, encodeId=77b81e074281f, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Mon Jun 12 09:50:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184241, encodeId=613018424191, content=不错的指南,为我们探讨研究提供了方针,给点个赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Apr 01 09:14:34 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184007, encodeId=5e6b18400eee, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Fri Mar 31 13:01:51 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184005, encodeId=aa4d18400599, content=已经学习,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRr4hYQTDrdLbsTChMzLetAadHkYtbdKribQFsv5vWbnhUYuQoVfqwW32yaOIO1BmBiaBPcSibicwgSAc/0, createdBy=5b192044357, createdName=流浪野医, createdTime=Fri Mar 31 12:52:19 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184004, encodeId=420f18400480, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=118f1734484, createdName=1def5ef1m18(暂无匿称), createdTime=Fri Mar 31 12:44:28 CST 2017, time=2017-03-31, status=1, ipAttribution=)]
                2017-03-31 1def5ef1m18(暂无匿称)

                好!

                0

              相关资讯

              Mayo Clin Proc:CHA2DS2-VASc评分可预测非房颤患者血栓事件和死亡的发生

              目的:为了确定CHA2DS2-VASc评分(充血性心力衰竭、高血压、年龄≥75岁、糖尿病、卒中或短暂性脑缺血发作、血管疾病、年龄65-74岁,性别)是否可以预测无心房颤动的植入式心脏监测设备患者发生血栓栓塞和死亡。患者和方法:利用罗切斯特流行病学项目的基础设施进行回顾性研究评估CHA2DS2-VASc是否可以预测无房颤患者的死亡,缺血性脑卒中,短暂性脑缺血发作,或全身性栓塞的发生。纳入标准为无心房

              中国循环杂志:阜外学者发现,房颤并非心脏再同步化治疗患者心衰再住院和死亡的独立危险因素

              近期,阜外医院刘尚雨等在本刊发文称,尽管合并房颤的心脏再同步化治疗(CRT)患者心衰再住院率增加,但房颤并非该类患者心衰再住院和全因死亡的独立危险因素。该研究回顾性收集2010-01 至2014-12 于阜外医院心律失常中心接受首次接受CRT的258 例患者临床资料,根据是否合并房颤,将患者分为房颤组和无房颤组。中位随访22 个月,死亡33 例(12.8%),心脏移植5例(1.9%),心衰再住院7

              JAMA:达比加群vs.华法林-预防非瓣膜性房颤患者发生骨折哪个更好?

              非瓣膜性心房颤动(NVAF)患者使用达比加群(dabigatran)治疗后发生骨质疏松性骨折的风险尚不清楚。近期,一项发表在权威杂志JAMA上的研究旨在评估达比加群与华法林在NVAF患者中发生骨质疏松性骨折的风险。此项研究使用由香港医院管理局管理的全港数据库进行回顾性队列研究。自2010年至2014年新诊断为NVAF的患者,予以达比加群或华法林,随访直至2016年7月31日。使用泊松回归比较达比加

              Stroke: 临床医生对抗凝治疗风险获益比看法有所改变

              目的:尽管大量证据表明脑缺血的房颤患者进行抗凝治疗获益,大量未使用已报道。方法:研究对象为以色列国家急性卒中评估调查登记研究中(NASIS)的房颤脑卒中患者,对受试者应用抗凝治疗作为二级预防进行评估。应用Logistic回归分析评估临床协变量对出院时抗凝治疗的影响,随着时间的推移对抗凝治疗的使用进行了评估,确定的抗凝治疗的障碍。结果:心房颤动患者发生急性脑缺血共1254例,(平均年龄77.2~10

              栓塞或出血:老年房颤抗凝的矛盾与抉择

              老年房颤患者有很多特点,尤其在血栓和出血方面。例如老年人群高血栓及高出血风险并存,同时老年房颤患者大多同时存在动脉系统血栓及静脉系统血栓,而且老年人各个系统处于退化状态,会反复发生多部位血栓。 目前抗栓现状则是“华法林困境”,即抗凝治疗率低和抗凝质量控制低。英国研究表明: 真实世界房颤华法林抗凝治疗不足。还有美国研究表明,老年房颤华法林抗凝治疗不足。我国的抗凝治疗率很低,目前在中国的大