west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "心房" 216 results
  • Evidence-based Treatment for a Patient with Ischemic Stroke Accompanied by Hypertension and Atrial Fibrillation

    Objective To formulate an evidence-based treatment plan for a patient with ischemic stroke accompanied by hypertension and atrial fibrillation. Methods We searched The Cochrane Library (Issue 4, 2006), SUMsearch (January 1980 to December 2006) and PubMed (January 1980 to December 2006) to identify randomized controlled trials (RCTs), systematic reviews (SRs) and meta-analyses about the efficacy and safety of anticoagulant therapy for ischemic stroke coupled with atrial fibrillation, and blood pressure lowering therapy for ischemic stroke coupled with hypertension. We evaluated the validity, reliability and feasibility of each study to identify the current best evidence. Results Four guidelines, 3 SRs and 6 RCTs were included. The evidence showed that low-intensity anticoagulant therapy was safe and effective for this patient, and that rapid blood pressure lowering therapy was not suitable for acute ischemic stroke. According to the current evidence, as well as the patient’s clinical condition and preference, low-intensity warfarin was given with a target INR (international normalized ratio) of 2.0. During convalescence, he was given oral fosinopril and indapamide. His symptoms were relieved after two weeks of treatment, and follow-up at one month indicated that this plan was suitable for the patient. Conclusions Anticoagulant therapy is still preferred for acute ischemic stroke accompanied by hypertension and atrial fibrillation. The current evidence suggests that warfarin is superior to other anticoagulants. The target INR should be adjusted individually, especially in old patients. The maintenance of a low INR level, if necessary, could maximise utility and minimise the risk of hemorrhage. Aspirin is recommended when anticoagulants cannot be tolerated. Intensive blood pressure lowering therapy is not reasonable for patients with acute ischemic stroke. Antihypertensive drugs like ACEI and low-dose diuretics may be chosen during convalescence.

    Release date:2016-08-25 03:36 Export PDF Favorites Scan
  • 左心房恶性肿瘤一例

    Release date: Export PDF Favorites Scan
  • The Control Study of CommunityBased Management and SpecialistBased Management of Warfarin Therapy in Elderly Patients with Atrial Fibrillation

    目的:心房纤颤是老年最常见的心律失常之一,并且带来了如外周血管血栓形成、肺梗死、脑卒中等并发症。口服抗凝治疗是预防该类并发症的有效手段,但监测繁琐、有药物不良反应风险等。本实验为寻找有效的房颤管理模式,设计了社区管理模式,并与专科管理模式进行对照,以研究社区管理模式是否适合老年房颤患者的管理。方法:纳入在我院就诊的老年房颤患者107名,随机分入社区管理组及专科管理组,其中专科管理组患者在珠海市人民医院门诊常规就诊,而社区管理组在所属社区进行治疗。对照比较在抗凝达标率、华法林相关不良反应事件发生率(出血、血栓事件)、及费用方面的差异。结果:与专科管理组比较,社区管理组在抗凝达标率(分别为612%,642%,Pgt;005)、出血及血栓事件(P值分别为0133,0279)发生率方面无明显统计学差异,但是在总体费用方面存在着统计学差异(Plt;0001)。结论:老年房颤患者华法林抗凝治疗在社区管理有着与专科管理相似的可行性、安全性及有效性,并且有费用方面的优势。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Amiodarone for Atrial Fibrillation

    目的:研究胺碘酮治疗心房颤动的疗效。方法:用胺碘酮治疗心房颤动患者68例(阵发性心房颤动40例,持续性心房颤动28例)。结果:连续用药治疗6个月显示治疗有效率分别为925%、75%。治疗12个月有效率分别为853%、68%。结论:胺碘酮治疗心房颤动安全有效,副作用小,可作为首选药。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • 心脏瓣膜置换同期应用双极射频消融术治疗心房纤颤患者的术后护理

    摘要:目的:总结54例心脏瓣膜置换同期应用双极射频消融术治疗心房纤颤患者的术后护理经验。方法:除做好瓣膜置换术后常规护理外,重视心律和心率的监测、电解质平衡的维持、应用胺碘酮的观察及护理、起搏器的观察、抗凝监测和健康指导与心理护理。结果:通过严密的监测和精心的护理,本组病例术后恢复良好,术后7~10 d出院。结论:做好心脏瓣膜置换同期应用双极射频消融术治疗心房纤颤患者的术后护理,认真观察患者瓣膜置换、消融术后心房纤颤治疗效果,为此类患者的生命质量提高提供了保证。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • Influence of Preoperative Left Atrial Dimension on the Effectiveness of Surgical Radiofrequency Ablation for Treatment  of Atrial Fibrillation

    Abstract: Objective To analyze the influence of preoperative left atrial dimension (LAD) on the effectiveness of surgical radiofrequency ablation for the treatment of atrial fibrillation (AF) through a 5-year postoperative follow-up of AF patients after surgical radiofrequency ablation. Methods Clinical data of 433 patients with persistent or permanent AF who received bipolar radiofrequency ablation procedures during concomitant cardiac surgery in Beijing Anzhen Hospital from 2006 to 2009 were retrospectively analyzed. All the patients were divided into 4 groups according to their preoperative LAD:Group A, 75 patients with their LAD<50 mm, including 22 males and 53 females with their average age of 56.50±10.05 years;Group B, 89 patients with their LAD ranging from 50 to 60 mm, including 32 males and 57 females with their average age of 55.63±10.28 years;Group C, 117 patients with their LAD ranging from 60 to 70 mm, including 41 males and 76 females with their average age of 55.13±10.96 years;and Group D, 152 patients with their LAD>70 mm, including 68 males and 84 females with their average age of 53.22±11.49 years. Postoperative ECG records right after surgery, before discharge, at 6 months and 1,2,3,4 and 5 years during follow-up were collected. The relationship between preoperative LAD and postoperative sinus rhythm restoration rate was analyzed. Results There was statistical difference in sinus rhythm restoration rate right after surgery(P=0. 011), before discharge(P=0. 002), at 6 months(P< 0. 001) and 1 year (P<0. 001), 2 years(P<0. 001), 3 years(P<0. 001), 4 years(P<0. 001) and 5 years(P= 0. 006) during follow-up among the 4 groups. Postoperative sinus rhythm restoration rates right at 6 months and 1,2,3, 4 and 5 years during follow-up was 90.4%, 89.9%, 90.3%, 91.3%, 89.1%, and 90.9% in Group A, 80.2%,79.0%,78.1%, 76.1%,72.5%,70.0% in Group B,74.7%,74.0%,71.2%,72.4%,70.0%, and 64.7% in Group C, and 61.8%,57.6%,56.8%,53.9%,50.7%,and 48.6% in Group D, respectively. Conclusion Patients with a larger preoperative LAD have a lower postoperative sinus rhythm restoration rate after surgical radiofrequency ablation for the treatment of AF.

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
  • 右心房横纹肌肉瘤手术治疗一例

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • “一鞘两伞” Hybrid 技术封堵室间隔缺损残余漏及左心室右心房通道一例

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • Comparison of Clinical Outcomes of Two Different Radiofrequency Ablation for the Treatment of Permanent Atrial Fibrillation of Patients with Rheumatic Valvular Heart Disease

    Objective To compare short-term clinical outcomes of bipolar/unipolar radiofrequency (RF) ablation for the treatment of permanent atrial fibrillation(AF) of patients with rheumatic valvular heart disease. Methods Clinicaldata of 124 patients with rheumatic valvular heart disease and permanent AF who underwent heart valve replacement and concomitant bipolar/unipolar RF ablation in Wuhan Asia Heart Hospital from February 2011 to December 2011 were retros- pectively analyzed. According to different RF ablation methods,all the 124 patients were divided into bipolar group and unipolar group. There were 62 patients in the bipolar group including 29 males and 33 females with their age of 44.20±8.61 years,and 62 patients in the unipolar group including 33 males and 29 females with their age of 46.40±9.48 years. Electrocardiogram examinations were performed at the time of intraoperative heart re-beating,the very postoperative day,7 days,1 month,3 months and 6 months postoperatively to detect restoration of sinus rhythm. Results There was no in-hospital death or ablation-related complication in either group. Aortic cross-clamp time(70.05±22.02 min vs. 54.47±20.65 min,P=0.025) and RF ablation time(25.12±3.00 min vs. 15.70±3.02 min,P=0.000)of the bipolar group were significantly longer than those of the unipolar group. At the time of intraoperative heart re-beating,the lst and 7th day after operation, sinus rhythm restoration rates were 88.71%,87.10%,80.65% respectively in the bipolar group,85.48%,77.42%,72.58% respectively in the unipolar group,and there was no statistical difference between the two groups (P>0.05). In the 1st,3rd and 6th postoperative month,sinus rhythm restoration rates of the bipolar group (79.03%,75.81%,72.58% respectively) were significantly higher than those of the unipolar group (59.68%,50.00%,48.38% respectively,P<0.05). Conclusion Clinical outcomes of RF ablation for the treatment of permanent AF of patients with rheumatic valvular heart disease are satisfactory. Unipolar RF ablation has the advantage of being time-saving and easier technique,while short-term sinus rhythm restoration rate of bipolar RF ablation is higher than that of unipolar RF ablation for the treatment of permanent AF.

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • Accuracy of Preoperative B-type Natriuretic Peptide Level in Predicting New Onset Atrial Fibrillation in Patients after Coronary Artery Bypass Grafting:A Systematic Review

    Objective To evaluate the value of preoperative B-type natriuretic peptide (BNP) level in predicting new onset atrial fibrillation (AF) in patients after coronary artery bypass grafting (CABG). Methods We electronically searched PubMed,EMbase,Cochrane library,CNKI and VIP databases from the establishment of those databases to November 2012. Evaluation standard of diagnostic tests was used to identify and screen literatures which investigated correlations between preoperative BNP levels and new onset AF of patients after CABG. Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to evaluate study quality of included literatures. RevMan 5.0 was used for heterogeneity test. Meta-Disc 1.4 software was used for meta-analysis. Included studies were weighted and then combined. Sensitivity,specificity,diag- nostic odds ratio (DOR),positive likelihood ratio,negative likelihood ratio and corresponding 95% confidence interval(95% CI)were calculated. Summary receiver operating characteristic (SROC) curve was drawn,and the area under the SROC curve (AUC) was analyzed. Results A total of 236 studies were identi?ed,and 5 studies met the eligibility criteria including 802 patients for analysis. There were 228 patients with postoperative new onset AF,and 574 patients without postoperative AF. The quality of the included literature was relatively high. DOR of preoperative elevated BNP level with postoperative new onset AF was 4.15 with 95% CI 2.90 to 5.95. Pooled sensitivity was 0.78 with 95% CI 0.72 to 0.83,pooled specificity was 0.58 with 95% CI 0.54 to 0.58,pooled positive likelihood ratio was 1.91 with 95% CI 1.42 to 1.56,pooled negative likelihood ratio was 0.42 with 95% CI 0.32 to 0.54,and the AUC of SROC was 0.79 (Q=0.72). Conclusion Preoperative elevated BNP level is significantly correlated with new onset AF after CABG,is a powerful predictor of postoperative AF,and can be used to predict new onset AF after CABG to a certain extent of reliability.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
22 pages Previous 1 2 3 ... 22 Next

Format

Content