心力衰竭治疗要点—培训课件.pptVIP

* 心室辅助装置 * 心室辅助装置 * 心脏移植　 在80年代初被接受为终末期心脏病的治疗方法 Cardiac transplantation is currently the only established surgical approach to the treatment of refractory HF, but it is available to fewer than 2500 patients in the United States each year According to the Organ Procurement and Transplantation Network (OPTN) database on March 1, 2008, men had an 87.5% 1-year survival in comparison with women at 85.5%. The 3-year survival was 78.8% versus 76.0% and the 5-year survival was 72.3% versus 67.5%, respectively. McCalmont V, Ohler L. Cardiac transplantation: candidate identification, evaluation, and management. Crit Care Nurs Q. 2008 Jul-Sep;31(3):216-29; quiz 230-1 * Indications for Cardiac Transplantation Absolute Indications in Appropriate Patients For hemodynamic compromise due to HF Refractory cardiogenic shock Documented dependence on IV inotropic support to maintain adequate organ perfusion Peak VO2 less than 10 mL per kg per minute with achievement of anaerobic metabolism Severe symptoms of ischemia that consistently limit routine activity and are not amenable to coronary artery bypass surgery or percutaneous coronary intervention Recurrent symptomatic ventricular arrhythmias refractory to all therapeutic modalities * * 2008ESC * 小结 从源头和进程上阻断心血管事件链，切实做到以预防为首，阻断心力衰竭的发生和发展 利尿剂是首要的基础用药 “生物学治疗”是心衰的关键 地高辛仍是重要的辅助治疗 正确选择植入性装置和心脏移植 * 谢 谢！ * According to the Organ Procurement and Transplantation Network (OPTN) database on March 1, 2008, men had an 87.5% 1-year survival in comparison with women at 85.5%. The 3-year survival was 78.8% versus 76.0% and the 5-year survival was 72.3% versus 67.5%, respectively. McCalmont V, Ohler L. Cardiac transplantation: candidate identification, evaluation, and management. Crit Care Nurs Q. 2008 Jul-Sep;31(3):216-29; quiz 230-1. * 强调了心力衰竭发展的全过程及其预防该指南在第一部分以显要位置介绍了心力衰竭发生和进展的各阶段。即从只有心衰危险因素（A阶段）到终末期心力衰竭（D阶段）发生和进展的全过程。其重要意义是强调高度重视并控制这些危险因素，在左室功能不全或症状出现之前便采取治疗措施以降低心力衰竭的病残率和病死率，更加注重从源头和进程上阻断心血管事件链，切实做到以预防为首，阻断心力衰竭的发生和发展。二、进一步强调关键的药物治疗