心脑血管急症救治现状与进展

Current status and progress in treatment of emergent cardio-cerebro-vascula diseases

本文通过查阅大量文献并结合近些年(尤其是近十年)心脑血管急救领域所取得的进步,介绍了急性冠脉综合征介入治疗的进步尤其是药物洗脱支架(DES)的临床应用,很好的改善了既往支架内再狭窄的状况;急诊床旁快速检测技术,如心梗心衰标志物心肌肌钙蛋白I(CTNI)、心肌肌钙蛋白T(CTNT)、脑钠素(BNP)的应用,大大缩短了急诊临床判断的时间,也提高了判断的准确性;介绍了2010年新的国际心肺复苏指南的变化,强调了持续不间断的、高质量的心脏按压在心肺复苏(CPR)中的重要性,埋藏式心律转复除颤器(Implantable Cardioverter-Defibrillator,ICD)、自动体外除颤器(AED)在防治恶性心律失常及心源性猝死时所起到的重要作用;高血压脑出血目前治疗方法的选择及各自的优缺点,并探讨了未来治疗的趋势。

In this article, by reading lots of documents and considering progress made in recent years （ especially the last dec- ade） in cardio-cerebro-vascula field, we summarize academic results and therapies, anticipate the treatment trends, introduce progress in interventional therapy for acute coronary artery syndrome, especially the clinical use of drug eluting stents, which solve the restenosis of stents. Technologies of emergency rapid bedside detection, such as cardiac infarction markers like CTNI, CTNT and BNP, have shortened the time and increased accuracy of clinical judgment. We introduce the updated 2010 version of New International Cardio- Pulmonary Resuscitation Guide, underline the importance of continuous and high qualified cardiac compression in CPR, introduce the important role implantable cardioverter-defibrillators and automated external defibrillators play in the prevention and cure of malignant arrhythmia and cardiogenic sudden death, and different treatments for cerebral hemorrhage, as well as discuss the treatment trends.