Bu Jun, Chen Mao, Cheng Xiaoshu, Dong Yifei, Fang Weiyi, Ge Junbo, Gong Yanjun, He Ben, Huang Lan, Huo Yong, Jia Shaobin, Jiang Jun, Li Yue, Li Zhao, Liang Chun, Liu Xuebo, Liu Zhenyu, Ma Xiang, Ma Yitong, Qian Juying, Shen Chengxing, Shen Difei, Shen Li, Shi Ruizheng, Su Xi, Sun Yingxian, Tang Yida, Wang Jianan, Wu Yue, Xiang Dingcheng, Xu Tongda, Xu Yawei, Yang Yuejin, Zeng Hesong, Zhang Cheng, Zhang Guogang, Zhang Ruiyan, Zhang Shuning, Zhang Yun, Zhang Zheng, Zheng Bo, Zhou Ning
College of Cardiovascular Physicians, Chinese Medical Association, Shanghai 200032, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Feb 29;40(2):147-151. doi: 10.12122/j.issn.1673-4254.2020.02.01.
The SARS-CoV-2 epidemic starting in Wuhan in December, 2019 has spread rapidly throughout the nation. The control measures to contain the epidemic also produced influences on the transport and treatment process of patients with acute myocardial infarction (AMI), and adjustments in the management of the patients need to be made at this particular time. AMI is characterized by an acute onset with potentially fatal consequence, a short optimal treatment window, and frequent complications including respiratory infections and respiratory and circulatory failure, for which active on-site treatment is essential. To standardize the management and facilitate the diagnosis and treatment, we formulated the guidelines for the procedures and strategies for the diagnosis and treatment of AMI, which highlight 5 Key Principles, namely Nearby treatment, Safety protection, Priority of thrombolysis, Transport to designated hospitals, and Remote consultation. For AMI patients, different treatment strategies are selected based on the screening results of SARS-CoV-2, the time window of STEMI onset, and the vital signs of the patients. During this special period, the cardiologists, including the interventional physicians, should be fully aware of the indications and contraindications of thrombolysis. In the transport and treatment of AMI patients, the physicians should strictly observe the indications for patient transport with appropriate protective measurements of the medical staff.
2019年12月始于武汉的新型冠状病毒肺炎疫情已在全国迅速蔓延。防控疫情的措施也对急性心肌梗死(AMI)患者的转运和治疗过程产生了影响,在此特殊时期需要对患者管理进行调整。AMI具有起病急、后果可能致命、最佳治疗窗口期短以及并发症频发(包括呼吸道感染、呼吸和循环衰竭)等特点,对此进行积极的现场治疗至关重要。为规范管理并促进诊断和治疗,我们制定了AMI诊断和治疗程序及策略指南,其中突出了5项关键原则,即就近治疗、安全防护、溶栓优先、转运至定点医院以及远程会诊。对于AMI患者,根据新型冠状病毒肺炎筛查结果、ST段抬高型心肌梗死(STEMI)发病时间窗以及患者生命体征选择不同的治疗策略。在此特殊时期,包括介入医师在内的心脏病专家应充分了解溶栓的适应证和禁忌证。在AMI患者的转运和治疗过程中,医师应严格遵守患者转运指征,对医务人员采取适当的防护措施。