终末期患者心脏植入型电子器械的缓和医疗现状及临床管理

Clinical Management and Palliative Care Status for End-stage Patients with Cardiovascular Implantable Electronic Devices

心脏植入型电子器械(CIED)包括起搏器、植入型心律转复除颤器(ICD)和心脏再同步化治疗(CRT)等。随着人口老龄化的增加及CIED植入适应证范围的逐渐扩大,CIED植入量逐年增加。但对于临床终末期患者,ICD或CRT联合ICD不但不能延长患者的生存期,反复的电除颤可能会给患者带来严重痛苦。临终患者CIED的管理成为影响终末期患者生存质量的重要问题,现就临终患者CIED的缓和医疗现状和临床管理决策中的影响因素以及临床处理策略展开综述。

Cardiovascular implantable electronic devices(CIED)include pacemaker,implantable cardioverter defibrillator(ICD)and cardiac resynchronization therapy(CRT).With the indications of CIED implantation expanding and the elderly population increasing,the number of CIED implantation is increasingly year by year.But for the end-stage patients,ICD or CRT combined with ICD can not prolong the survival period of patients,and repeated defibrillation may bring severe pain to patients.The management of CIED in terminal patients has become an important issue that affects the quality of life of end-stage patients.Therefore,this article reviews the issue about the palliative care status,the influencing factors in clinical management decision-making and clinical treatment strategies for the end-of-life patients with CIED.