围绕急诊室的抗凝血实践 心脏转变用于心房动和动
Thomas Maouris1, Peter Del Mar1, Nathan Brown1
1Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Emergency medicine Australasia : EMA
|March 1, 2026
概括
大多数因心房 (AF) 或动而接受心脏转移的急诊室患者都接受基于指南的抗凝药. 然而,需要改进后续和护理途径,以减少AF心脏转变后的高复诊率.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 药理学 药理学是指药理学的学科.
背景情况:
- 心房动 (AF) 和动是常见的心律失常症,需要心脏转变.
- 国际指导方针建议针对接受直流心脏转换 (DCCV) 的患者使用特定的抗凝方案.
- 在急诊室 (ED) 环境中遵守这些指南对于患者的安全和结果至关重要.
研究的目的:
- 评估在DCCV期间对ED中AF/的抗凝血指南的遵守情况.
- 确定患者的特征和与遵守指南相关的结果.
- 评估抗凝管理对ED复诊率的影响.
主要方法:
- 在一个大都会ED (2020-2023) 中,对158名为AF/flutter接受DCCV的患者进行了回顾性研究.
- 收集有关心律不整的数据,细节,抗凝时间和结果.
- 分析基于2024年欧洲心脏病学会对抗凝血的标准.
主要成果:
- 观察到高度遵守心脏转变前 (94%) 和心脏转变后 (90%) 的抗凝血指南.
- 直接口服抗凝剂 (DOAC) 经常使用,适当剂量在88.2%的患者中使用.
- 在CHA2DS2-VA得分≥2 (p<0.01) 的患者中,观察到更高的坚持;然而,ED复诊率很高 (30天后17.1%,12个月后46.2%).
结论:
- 与指导方针一致的抗凝药对于ED心脏转变的AF/飞是常见的.
- 抗凝剂剂量和术后管理的变化仍然存在,特别是在风险较低的患者中.
- 加强后续和结构化护理途径对于缓解ED心脏转变后的高复诊率至关重要.
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