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Jingdong book

冠心病规范化治疗

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Books Medical Science Internal Medicine

Jingdong book

冠心病规范化治疗

Name: 冠心病规范化治疗
Brand: Jingdong book
SKU: 3117022911
Price: 43.40 USD
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Content Description

《冠心病规范化治疗》的真正意义正是在这方面做出有益的探索，强调循证医疗规范化。在一定程度上体现人文科学主义行医态度以及重点突出冠心病的预防观念。中心精神在于体现科学的行医观念，使医生不仅要知道“做什么”更要知道“不做什么”，哪些检查手段或治疗是不能使患者受益的，以循证医学为指导代替以往经验行医的模式。提醒广大的临床医生在新医学模式下，首先具备良好的医德医风，重视人文素质的提高，时时考虑患者利益，一切为了公众健康，同时具备扎实的临床基本功，做好知识的系统更新，对交叉学科的知识进行整合，立体化、系统化、全方位地审视疾病，制定出合理的、积极的和更切实的治疗方案。《冠心病规范化治疗》从流行病学到治疗全面涵盖冠心病诊断及治疗相关知识，帮助心内科医师更全面地了解冠心病流行病学现状、更准确地分析和评价各项辅助检查结果，更专业地掌握各种治疗进而选择最为适宜的治疗手段，并进一步了解冠心病康复治疗的内容和意义。

Catalogue

第一篇冠心病药物治疗
第一章稳定型心绞痛的药物治疗
第二章不稳定型心绞痛的药物治疗
第三章急性心肌梗死的药物治疗
第四章无症状心肌缺血的药物治疗
第五章心源性猝死的药物治疗
第六章冠状动脉粥样硬化性心脏病诊断治疗标准(草案)

第二篇冠状动脉介入治疗
第一章概述
第二章 PCI的适应证与策略选择
第三章经皮冠状动脉介入方法的选择
第四章冠状动脉成像及血流动力学评价
第五章 PCI的药物治疗
第六章对比剂的选择和应注意的问题
第七章复杂病变和特殊人群的治疗策略
第八章 PCI并发症的预防和处理
第九章冠状动脉粥样硬化性心脏病介入诊疗标准(草案)

第三篇冠心病外科治疗——冠状动脉旁路移植术
第一章冠状动脉旁路移植术的适应证选择
第二章冠状动脉旁路移植术的血管移植物
第三章非体外循环冠状动脉旁路移植术
第四章再次冠状动脉旁路移植术
第五章急诊冠状动脉旁路移植术
第六章心肌梗死并发症的外科治疗
第七章冠状动脉旁路移植术的危险因素
第八章冠状动脉旁路移植术的常见并发症及其防治
第九章冠状动脉旁路移植手术后的药物治疗

Book Abstract

舌下含服或喷雾用硝酸甘油仅作为心绞痛发作时缓解症状用药，也可在运动前数分钟使用，以减少或避免心绞痛发作。长效硝酸酯制剂用于减低心绞痛发作的频率和程度，并可能增加运动耐量。长效硝酸酯类不适宜用于心绞痛急性发作的治疗，而适宜于慢性长期治疗。每天用药时应注意给予足够的无药间期，以减少耐药性的发生。如劳力型心绞痛患者日间服药，夜间停药，皮肤敷贴片白天敷贴，晚上除去。
硝酸酯类药物的不良反应包括头痛、面色潮红、心率反射性加快和低血压，以上不良反应以短效硝酸甘油更明显。第1次含用硝酸甘油时，应注意可能发生体位性低血压。使用治疗勃起功能障碍药物西地那非者24小时内不能应用硝酸甘油等硝酸酯制剂，以避免引起低血压，甚至危及生命。
对由严重主动脉瓣狭窄或肥厚型梗阻性心肌病引起的心绞痛，不宜用硝酸酯类制剂，因为硝酸酯类制剂降低心脏前负荷和减少左室容量，能进一步增加左室流出道梗阻程度，而严重主动脉瓣狭窄患者应用硝酸酯类制剂也因前负荷的降低进一步减少心搏出量，有造成晕厥的危险。
硝酸甘油的耐药是一个不可忽视的临床现象。目前硝酸甘油的耐药机制仍不十分明确。目前的学说主要有巯基耗竭学说、神经激素激活学说、血管内容量扩张学说、超氧阴离子学说等多种解释，但任何一种学说均无法完全对耐药现象进行解释。科学合理地用药是避免耐药的主要方法，即应提供硝酸酯类药物一定的空白间期，而避免长期连续用药。一般建议每日提供8小时的低硝酸酯间期。静脉制剂尽量限于危重病例应用，可每日给药10～16小时，避免长期用药连续超过24小时。口服制剂可1日多次应用，且强调“偏时性应用”，如每日2次，则早晨7：00-8：00服用，下午3：00-4：00服用，最后一粒不晚于下午6：00，以使夜间存在一定的空白间期。或采用1日1次长效制剂，通过药物本身的药代动力学设计提供低硝酸酯间期。据报道有些药物与硝酸酯类合并使用可助于减少耐药现象的发生，包括含巯基的ACEI（卡托普利）、肼屈嗪、抗氧化剂、蛋白激酶C拮抗剂等。但这些均缺乏确凿的临床证据，因此并不主张单纯为防止硝酸酯的耐药现象而加用其他药物。

Introduction

冠心病是本世纪最影响人类健康的疾病之一，其发病率之高、后果之严重众所周知，在生活水平快速提高的中国，这种特点表现得更为突出。21世纪是医学飞速发展的时期，在冠心病领域，从诊断到治疗，各种技术手段层出不穷、日益更新。然而技术的发展并不能解决临床的所有问题，并且在有些情况下，过度医疗和技术的滥用还会带来诸多临床问题。如过度依赖药物治疗以及介入、手术等手段，轻视预防环节，疏于疾病管理，使得临床医师更容易强调单一病变而忽视患者的整体状况。
本书的真正意义正是在这方面做出有益的探索，强调循证医疗规范化。在一定程度上体现人文科学主义行医态度以及重点突出冠心病的预防观念。中心精神在于体现科学的行医观念，使医生不仅要知道“做什么”更要知道“不做什么”，哪些检查手段或治疗是不能使患者受益的，以循证医学为指导代替以往经验行医的模式。提醒广大的临床医生在新医学模式下，首先具备良好的医德医风，重视人文素质的提高，时时考虑患者利益，一切为了公众健康，同时具备扎实的临床基本功，做好知识的系统更新，对交叉学科的知识进行整合，立体化、系统化、全方位地审视疾病，制定出合理的、积极的和更切实的治疗方案。本书从流行病学到治疗全面涵盖冠心病诊断及治疗相关知识，帮助心内科医师更全面地了解冠心病流行病学现状、更准确地分析和评价各项辅助检查结果，更专业地掌握各种治疗进而选择最为适宜的治疗手段，并进一步了解冠心病康复治疗的内容和意义。
最后，让我们认真学习和落实科学发展观，高举公益、规范、预防和创新四面旗帜，实现人文、临床和基本功的回归，开创我国心血管疾病防治的新局面。

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Jingdong book

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