我国基层医疗心房颤动抗凝管理的现状与展望

Primary care for atrial fibrillation patients with anticoagulation therapy in China:status quo and future perspective

随着心房颤动(房颤)患病率不断提升, 以缺血性卒中和血栓栓塞疾病为代表的房颤相关并发症的发生率和危害程度也在逐年增加。按照国家推行房颤分级诊疗的部署计划, 今后基层医疗卫生机构将承担主要的房颤慢病管理工作, 规范的社区管理是提高房颤慢病管理效果不可缺少的条件。目前我国的基层医疗房颤抗凝管理主要呈现抗凝不规范、房颤合并症和危险因素管理疏漏的问题。文章对目前我国基层医疗中房颤抗凝管理的现状、产生原因及试行的改进措施进行综述, 并对今后的发展趋势作出展望, 为更好更快推进房颤分级诊疗提供参考。

With the increasing prevalence of atrial fibrillation(AF),the incidence of its complications,such as ischemic stroke and thromboembolism is also increasing.According to the two-way referral system proposed by health authorities,AF management should be carried out mainly in primary care settings;and studies show that general practitioners play an indispensable role in AF management.At present,however,the inappropriate anticoagulation,AF complications and risk awareness are three major problems in the primary care of AF management in China.This article reviews the status quo and future prospect of AF management in primary care to provide suggestions for better management of AF in primary care level.