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经皮冠状动脉介入治疗后的患者管理

Patient Management Following Percutaneous Coronary Intervention.

作者信息

Wennberg Erica, Abualsaud Ali O, Eisenberg Mark J

机构信息

Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, Quebec, Canada.

MD/PhD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

JACC Adv. 2024 Dec 18;4(1):101453. doi: 10.1016/j.jacadv.2024.101453. eCollection 2025 Jan.

Abstract

Percutaneous coronary intervention (PCI) is a mainstay procedure for the treatment of coronary artery disease. PCI techniques have evolved considerably since the advent of PCI in 1978, and with this evolution in techniques has come changes in the best practices for patient management following PCI. The objective of this review is to provide a comprehensive overview of key considerations in patient management following PCI. The long-term management of patients post-PCI should follow 3 main principles: 1) lifestyle modification and reduction of risk factors; 2) implementation of secondary prevention therapies; and 3) timely detection of restenosis. Best practices in achieving these principles include promotion of smoking cessation, regular physical activity, and a healthy diet, as well as blood pressure, diabetes mellitus, lipid, and weight management; prescription of secondary prevention therapies balancing ischemic and bleeding risk; and avoidance of routine surveillance for restenosis.

摘要

经皮冠状动脉介入治疗(PCI)是治疗冠状动脉疾病的主要手段。自1978年PCI问世以来,PCI技术有了很大发展,随着技术的发展,PCI术后患者管理的最佳实践也发生了变化。本综述的目的是全面概述PCI术后患者管理的关键注意事项。PCI术后患者的长期管理应遵循3个主要原则:1)生活方式改变和危险因素降低;2)实施二级预防治疗;3)及时检测再狭窄。实现这些原则的最佳实践包括促进戒烟、定期体育活动和健康饮食,以及血压、糖尿病、血脂和体重管理;开具平衡缺血和出血风险的二级预防治疗处方;避免对再狭窄进行常规监测。

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