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2014房颤病人脑卒中预防指南
原作者: 李辉 译 肖锋 校 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2014-05-19
关键词:脑卒中;预防

 Title: 2014 Atrial Fibrillation Guidelines on Stroke Prevention
题目:2014房颤病人脑卒中预防指南
Author 作者: Feng Xiao (肖锋)
李辉 译 肖锋 校
The “2014 Guideline for the Management of Patients with Atrial Fibrillation” was created to reflect the latest research when it comes to treating atrial fibrillation—an irregular heart rhythm affecting 2.6 million Americans.
“2014房颤病人处理指南”的编撰是用以反映治疗房颤的最新研究进展,这一疾病表现为心律失常,影响着超过260万美国人。
Released in March 2014 by the American College of Cardiology, American Heart Association and Heart Rhythm Society in collaboration with the Society of Thoracic Surgery, this document incorporates knowledge from the latest research to provide recommendations for the management of atrial fibrillation.
这一文件由美国心脏病学院、美国心脏协会及心律学会联合胸外科医师学会共同于2014年3月发布,其涵盖了最新研究的观点并为房颤的治疗提供指导。
It helps answer questions like “How can patients with atrial fibrillation prevent stroke?” and “How can I estimate a patient’s risk for complications?”
它可以帮助回答很多问题,比如“房颤患者怎样预防脑卒中?”以及“我怎么估计患者出现并发症的风险?”。
Here’s what we should know about the latest atrial fibrillation guidelines:
下面就是我们应该知道的关于房颤预防的最新指南:
Calculating Stroke Risk:
脑卒中风险计算:
Stroke is the most common type of serious complication associated with atrial fibrillation.
脑卒中是与房颤相关的最常见的一种严重并发症。
Certain factors can further increase risk for stroke, such as high blood pressure, so it’s important to identify those at highest risk for stroke and take action to reduce risk of complications.
某些因素可以进一步增加脑卒中的风险,比如高血压,所以明确哪些病人具有脑卒中高发风险并采取措施减少发生并发症的风险就显得十分重要。
In the past, experts have used a simple risk calculator to assess stroke risk.
过去,专家们已经使用过简单的风险计算方法以评估脑卒中风险。
However, new guidelines recommend using a more detailed risk calculator that provides more information and can more accurately identify those at low, moderate and high risk for stroke.
然而,新指南推荐使用一个更加详细的风险计算方法以提供更多的信息,并能更加精确地识别具有低度、中度或高度卒中风险的患者。
Reducing Risk for Stroke:
减少脑卒中风险:
Aside from lifestyle changes, medication is one of the best ways to reduce stroke risk in patients with atrial fibrillation.
除了改变生活方式,药物治疗是减少房颤病人卒中风险的最好的方式之一。
Patients with a history of stroke are at higher risk for a future cardiac event, so anti-clotting medication (oral anticoagulation) is recommended.
有脑卒中史的患者未来发生心脏事件的风险高,所以推荐使用抗凝药物(口服抗凝)。
Previously, coumadin (warfarin) was the only recommended anti-clotting drug, but experts expanded the list to newer drugs including dabigatran, rivaroxaban and apixaban.
以前,可迈丁(华法林)是唯一被推荐的抗凝药物,但是专家们扩大了选择以囊括新药如达比加群、利伐沙班、阿哌沙班。
Aspirin Use: Past guidelines recommended that patients with low cardiovascular risk should take aspirin as an added precaution to help prevent stroke.
阿司匹林的使用:过去的指南推荐低心血管事件风险的患者服用阿司匹林作为一种额外的预防措施以预防卒中。
This recommendation was removed in the 2014 guidelines based on lack of data linking aspirin use to reduced stroke risk.
在2014年的指南中这一建议因缺乏服用阿司匹林减少脑卒中风险的数据而被去除。
Ablation Therapy:
射频消融:
Radiofrequency ablation therapy is a non-surgical procedure that can help relieve symptoms and improve quality of life in certain patients with atrial fibrillation.
对某些房颤患者,射频消融疗法是一种无需手术并能帮助缓解症状,改善生活质量的方法。
During ablation, tiny areas of the heart are destroyed to help prevent electrical impulses that can trigger an abnormal heart beat.
在消融过程中,心脏细小的区域被破坏以防止电脉冲触发不正常的心脏跳动。
The 2014 guidelines encourage broader use of this treatment for certain patients with atrial fibrillation.
2014年的指南鼓励对这部分房颤病人更广泛地使用这一治疗方法。
Reference 参考文献:
http://circ.ahajournals.org/content/early/2014/04/10/CIR.0000000000000040.citation

文章来源:《中华急诊医学杂志》编辑部