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Jingdong book

心力衰竭的管理：外科卷

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Jingdong book

心力衰竭的管理：外科卷

Name: 心力衰竭的管理：外科卷
Brand: Jingdong book
SKU: 3117125951
Price: 61.82 USD
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心力衰竭是各类心脏疾病发展的最终结果和死亡原因，已成为心脏病学领域中最常见的疾病之一，也是治疗的难点。

《心力衰竭的管理：外科卷》的原著作者队伍。主编杰·拉曼博士是美国芝加哥大学成人心脏外科主任，为国际上著名的心脏外科专家，在心力衰竭的外科治疗和管理方面经验非常丰富，学术造诣高。其他参编者为来自美国、英国、日本、澳大利亚、以色列等国的著名心脏外科中心，均为心脏外科领域的著名专家。

译者队伍强大。主译赵强教授为瑞金医院心外科主任，我国著名的心脏外科专家。

Content Description

《心力衰竭的管理：外科卷》是《心力衰竭的管理：内科卷》的姊妹篇，是专门论述心力衰竭内、外科治疗和管理方法的学术专著。

《心力衰竭的管理：外科卷》系统阐述了心力衰竭的病理生理，外科治疗策略；心脏移植、OPCAB、二尖瓣修复、心室成形及机械辅助等多种技术在心力衰竭治疗中的应用；使用起搏器除颤装置、外科消融技术治疗心力衰竭中的心律失常；特殊情况心力衰竭如肺栓塞右心衰竭和小儿心力衰竭的治疗；麻醉和围手术期血流动力学管理；并概述了心力衰竭治疗的新技术。

《心力衰竭的管理：外科卷》可作为各级心脏外科医生的参考书，也可为心血管内科医生、麻醉医生、监护室医生的临床工作提供参考。

Author Description

杰·拉曼博士，是美国芝加哥大学成人心脏外科主任、外科学教授，国际著名的成人心脏外科专家。四十多位参编者分别来自美国、英国、日本、澳大利亚、以色列等国的著名的心脏外科中心，均为心脏外科领域的著名专家。

赵强博士，上海交通大学医学院附属瑞金医院心脏外科主任、教授、博士生导师。中华医学会胸心血管外科学会委员、中国医师协会心血管外科分会常委、美国胸外科医师协会(STS)委员，为国内著名的心脏外科专家，在冠心病、心脏瓣膜病、先天性心脏病、大血管、心脏移植等心血管病外科方面有很深造诣。

Catalogue

1．外科概况
2．病理生理——临床表现和现代治疗
3．外科治疗策略
4．终末期心力衰竭：移植与非移植外科方法
5．心脏移植治疗终末期心脏病
6．OPCAB治疗心力衰竭
7．循环辅助作为心肌恢复或移植过渡
8．左心室成形术治疗缺血性心肌病
9．改良Dor法及其失败原因
10．二尖瓣修复术
11．永久性机械循环辅助装置终点治疗
12．实用外科方法与技术
13．室性心动过速导管和外科治疗
14．心力衰竭患者房颤导管消融治疗
15．房颤的外科治疗
16．起搏器、除颤装置和术后心律失常的处理
17．心室束缚、形态改变和心肌梗死限制
18．其他技术处理特殊情况：肺动脉血栓内膜剥脱术治疗右心衰竭
19．小儿心力衰竭的外科治疗和先天性心脏病引起的心力衰竭
20．麻醉及血流动力学管理
21．围术期及ICU处理，液体管理和肾功能支持
22．新疗法和新起点

Book Abstract

异常负荷作用于心肌可能是由于长期压力负荷过重（例如体循环动脉高血压）或者容量负荷过重（例如主动脉瓣及二尖瓣反流）。
导致心力衰竭的外部原因包括缩窄性心包炎、心动过速，由于严重贫血或大的动静脉瘘或分流可导致高排低阻性心力衰竭。
2．1．2 心力衰竭的进展
心力衰竭发生和发展过程中的潜在机制包括原发损害后导致的心室重构。正常心肌细胞代谢过程中建立了一个破坏性的恶性循环，导致心肌细胞肥大及纤维化，这一导致心室超微结构改变的渐进过程称为重构。重构的发生起初是一种改善心功能的适应性反应，不幸的是，长时间的反应就产生负面效应和异常适应性改变。
2．1．3 分子及细胞学基础
多种因素在细胞水平作用于心室。例如，体循环动脉压力过高激活在成人体内通常是静止的胚胎生长因子，这些因子加速蛋白质合成及肌细胞生长，最终导致心室肥大。舒张功能不全进展为收缩功能不全，最终发展成巨大、扩张、收缩功能严重低下的心室。
心肌梗死是另一个诱发心室重构的导火索。不可逆性心肌损伤致使心脏失去收缩功能，剩余心肌发生代偿性改变。这一功能性超负荷，作用于未发生心肌梗死的区域，加上心肌梗死区域发生内在改变（如心肌细胞肌丝滑脱），就会发生重构。这个过程最终导致心腔扩大，产生严重的功能失常。
心肌重构的产生机制是复杂的，而且尚未研究透彻。目前的假设学说集中于一些细胞活性因子及生长因子，例如肿瘤坏死因子。心力衰竭患者心肌中发现肿瘤坏死因子水平增高。肿瘤坏死因子水平增高可能是通过包括诱导一氧化氮合酶等机制从而导致心肌细胞功能异常的。
虽然心力衰竭的异常适应性改变如果在早期发现并获得成功治疗，是可以逆转的，但是进一步的细胞学改变导致心脏正常区域发生细胞凋亡一程序性细胞死亡纤维增生，最终造成永久性功能损害。
慢性充血性心力衰竭的共同结局是收缩功能不全，可以理解为左心室在收缩期无法将其内容物（血液）搏出。虽然单独使用时左心室射血分数是一个相对较弱的预后指标，但是它仍最经常地用于客观评估心力衰竭的严重程度。
左心室无法以正常的速率填充至正常容量，称之为舒张功能不全。在某些舒张功能不全患者，收缩功能可以正常。多种因素可导致这种情况发生，包括严重的左心室肥大、限制性浸润性心肌病、缩窄性心包炎等。目前没有精确的方法来量化舒张功能不全，也没有有效的方法来治疗或控制舒张期功能障碍，因此病情会逐步加重。
……

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