冠状动脉介入球囊扩张导管与支架在采购选型中的技术评估

近年来,随着我国介入医学的迅速发展,采用介入医疗技术开展微创介入手术已成为外科技术的发展方向。在心血管介入方面,冠脉介入治疗（PCI）已在全球广泛应用,与之相关的心血管介入球囊扩张导管、支架等医疗器械也快速发展。本文针对冠状介入治疗中使用的球囊扩张导管和冠脉药物洗脱支架等介入器械的技术发展现状、发展趋势和在采购选型中的技术评估进行分析。     

介入放射学临床应用及新进展

介入医学即通过X射线、CT和超声等影像的导向，借助专用器械治疗躯体疾病的方法，广义地讲也应该涵盖利用内窥镜、胸腔镜、腹腔镜等设备非直视下手术。本文从影像学设备、支架技术、导管栓塞技术等三方面阐述介入技术的临床应用及最新进展。介入放射学是近几年迅速发展起来的学科，现已被称为除内科、外科以外的第三种临床治疗方法。     

介入放射学临床应用及新进展

介绍入医学即通过X射线，CT和超声等影像的导向，借助专用器械治疗躯体疾病的方法，广义地讲也应该涵盖利用内窥镜，胸腔镜，腹腔镜等设备非直视下手术，本文从影像学设备，支架技术，导管栓塞技术等三方面阐述介入技术的临床应用及最新进展，介入放射学是近几年迅速发展起来的学科，现已被称为内科，外科以外的第三临床治疗方法。     

颅内动脉瘤介入器械的现状与进展

颅内动脉瘤介入器械在临床已得到了大规模的应用,并已成为主要有效的治疗手段。本文对栓塞弹簧圈与辅助颅内支架、液体栓塞材料、颅内覆膜支架以及新型的血管重建装置等颅内瘤介入器械的治疗方法与原理、设计特点、技术改进方向及最新发展等方面进行了简要阐述。     

介入器械的普及应用推动了冠脉介入治疗的发展

近年来,中国心脑血管疾病患病率逐年提高,急剧增长的心脏病患者刺激了中国心脏介入手术和冠脉支架需求的快速增长,PCI手术、冠脉支架(药物洗脱支架)植入数量也大幅增加.本文主要针对心血管介入治疗器械的应用及其技术指标进行论述,并对该领域内主要器械的技术发展趋势进行了展望.     

心血管科器械的进展

在整个医疗器械行业中,心血管植入装置市场是医疗器械行业中发展最快的一个分支,正因为如此,心血管装置的制造商们为保持先进需要不断地努力奋斗。在医疗器械行业内,就治疗价值和年创收额而言,心血管科器械(诊断和治疗器械)是最重要的一个部份。从手术分类来说。心血管介入和植入装置可分为三类:起搏器和植入式心复律除颤器(ICDs)。心脏瓣膜,内支架。在世界范围内,心血管病是人类最重要的死因之一。医     

数字减影血管造影复合手术室管理专家共识

数字减影血管造影(DSA)复合手术室是应用介入设备、介入器械对人体疾病实施诊疗技术的场所,可同时进行导管介入治疗、心脑血管外科手术治疗等。为了规范DSA复合手术室内工作的临床医生、护士及相关技术人员等医疗行为,中国医学装备协会护理装备与材料分会手术装备与材料专业委员会组织专家形成了“DSA复合手术室管理专家共识”,以促进DSA复合手术室管理水平的提升。     

导读

01专题
　　介入?植入
　　由于人口老龄化以及社会经济发展带来居民饮食结构的改变，我国心血管疾病发病率逐年提高，中国正成为心血管疾病发病率最高的国家之一。因此，在相当长的一段时间内，心脑血管疾病的有效治疗都将会是一个重大命题。介入治疗具有介入创伤小、手术危险小、疗效明显等特点，成为治疗心脑血管疾病的主要治疗方式。《介入器械分类及其发展趋势》一文回顾了介入治疗装置及器械的发展现状，对国际产业发展趋势进行介绍，同时对国内介入治疗产业发展面临的机遇与挑战进行分析。     

医用耗材成本效益分析在HIS上的研发与应用

1引言以人工器官、介入技术等为代表的医用贵重高耗材料的广泛应用(例如心脏起博器、心脏瓣膜、导管、支架、人工关节、钢板和内固定系统等),使得医用耗材的用量正以惊人的速度逐年递增。据统计,近年来医用卫生耗材的年用量已达医院医疗毛收入的6%～16%,已经达到或超过医疗器械     

第三届植入介入医疗器械中国峰会即将在沪召开

由UBM Conferences主办,MEDTEC China官方支持举办的第三届植入介入医疗器械中国峰会将于2013年5月23日～5月24日在中国上海举行。本届峰会将邀请国内外的权威官员、行业专家、医生以及来自成品医疗器械制造、加工企业、医疗技术供应商及服务商界的代表,就全球及中国植入介入医疗器械行业所面临的机遇和挑战、植入介入材料和器械的研     

导管床专用臂托的设计制作及临床应用

目的：基于心血管疾病介入手术治疗经桡动脉穿刺术需要，设计制作导管床专用臂托。方法：对身高分别为150～160cm、160～175cm、175～185cm人群的肩宽、手臂长度进行测量，确定专用臂托及其底座的适宜尺寸，并绘制设计图纸。选用市售厚度为5mm的密度板作为制作材料，根据设计图纸制作导管床专用臂托。结果：经近100例心血管疾病患者介入手术治疗的临床实际运用，取得了非常满意的效果。结论：在心血管疾病介入手术治疗经桡动脉穿刺术中，使用自制的密度板材质导管床专用臂托，可使手术更加方便、灵活，患者感到舒适、实用。     

The Emerging Role of Nutraceuticals in Cardiovascular Calcification: Evidence from Preclinical and Clinical Studies

Cardiovascular calcification is the ectopic deposition of calcium-phosphate crystals within the arterial wall and the aortic valve leaflets. This pathological process leads to increased vascular stiffness, reduced arterial elasticity, and aortic valve stenosis, increasing the risk of cardiovascular diseases. Although cardiovascular calcification is an increasing health care burden, to date no medical therapies have been approved for treating or preventing it. Considering the current lack of therapeutic strategies and the increasing prevalence of cardiovascular calcification, the investigation of some nutraceuticals to prevent this pathological condition has become prevalent in recent years. Recent preclinical and clinical studies evaluated the potential anti-calcific role of nutraceuticals (including magnesium, zinc, iron, vitamin K, and phytate) in the progression of vascular calcification, providing evidence for their dietary supplementation, especially in high-risk populations. The present review summarizes the current knowledge and latest advances for nutraceuticals with the most relevant preclinical and clinical data, including magnesium, zinc, iron, vitamin K, and phytate. Their supplementation might be recommended as a cost-effective strategy to avoid nutritional deficiency and to prevent or treat cardiovascular calcification. However, the optimal dose of nutraceuticals has not been identified and large interventional trials are warranted to support their protective effects on cardiovascular disease.     

介入导管室防控感染管理的研究进展

近年来介入治疗已被广泛用于临床,对多种心脏疾病和外周血管疾病的诊疗作用明显,具有其他方法无法取代的优势。随着介入医疗器械精细程度的不断提高,应用的种类持续增多,放射线的结合运用,使介入导管室的相关感染风险增加,因此导管室的防控感染管理工作至关重要。介入导管室发生感染的风险因素较多,如管理制度欠缺、空气环境以及无菌物品配备等方面情况,因此感染管理工作的实施要着眼于多方面内容。应根据介入导管室的感染情况制订防控感染管理工作内容,不仅要注重管理体系的改革和完善,亦需高度重视感染源的控制,并对介入导管室的病区进行严格的管理,重视介入导管室防控感染管理工作的专业培训,持续加强工作人员的责任意识和工作能力,保证防控感染管理工作有条不紊的开展。本文旨在对介入导管室防控感染管理的研究进展进行综述。     

镍钛合金材料在脑血管介入器械中的应用

对镍钛合金材料的发展与现状、材料性能、医学基础研究、在脑血管介入医疗器械中的应用等方面分别作了简要阐述。     

Interventional Modalities to Treat Cancer-Related Pain

Abstract

Cancer-related pain is a significant cause of morbidity in those affected by both primary and metastatic disease. Although oral, transdermal, and parenteral opioid medications are an integral part of the World Health Organization's analgesic ladder, their use may be limited by side effects. Fortunately, there are advanced interventional pain management strategies effective in reducing pain in the cancer patient while mitigating the aforementioned side effects. Celiac plexus blocks and neurolysis have been proven effective in treating cancers of the abdominal viscera (ie, pancreas). Transversus abdominis plane blocks, neurolysis, and catheter placement can be used to treat cancer pain associated with the abdominal wall. Peripheral nerve blocks and catheter placement at the brachial and lumbosacral plexus or peripheral nerves treat cancer pain associated with the upper and lower limbs, whereas paravertebral and intercostal blocks treat cancer pain associated with the chest wall and ribs. Finally, alternate drug delivery methods such as intrathecal drug delivery systems concentrate medication at central opioid receptors without affecting the peripheral receptors implicated in unwanted side effects. This article provides an overview of these interventions, including indications, contraindications, and potential complications of advanced interventional pain management options available for the treatment of intractable cancer-related pain.     

The Massachusetts General Hospital Vascular Center: Emergence of a Multidisciplinary Program Designed to Improve Quality Outcomes for Patients

Abstract

The prevalence of cardiovascular disease in the United States is extensive and growing rapidly. Contributing factors include the aging population, tobacco abuse, obesity, and diabetes, all of which increase the prevalence of cardiovascular diseases. Treatment paradigms for cardiovascular disease have also been rapidly evolving; minimally invasive, catheter-based approaches are increasingly used as first-line therapy. Physicians from a variety of specialties have responded to this growing patient population and treatment paradigm shift by enhancing their training and expanding their practices to better care for these complex patients. This trend is a natural response of specialists to the evolving needs of their patients. In the vascular field, however, it has led to physicians acquiring skill sets that are new for that specialty and that go beyond the traditional boundaries of their practice, and which may overlap with skills classically practiced by other specialists. Surgeons are learning endovascular techniques previously performed by interventional radiologists; cardiologists are utilizing their knowledge about atherosclerosis and their catheter skills to manage noncardiac disease; neurologists and neurosurgeons are developing catheter-based techniques; and nephrologists are performing dialysis-access intervention. As a result, there is now much more overlap in the capabilities of—and services offered by—each specialty. Unhealthy and counterproductive competition among traditional disciplines has developed in the field of vascular care. This article describes the development of a multispecialty collaborative vascular center at a large urban academic medical center to demonstrate a new practice paradigm designed to improve quality of care for patients and enhance collaborative professional education and research.     

正确使用数字减影血管造影机减少介入手术中的辐射吸收剂量

目的:通过分析介入手术治疗中数字减影血管造影(DSA)参数,探讨减少辐射吸收剂量的途径及防护方法.方法:对随机选取的1200例各类介入手术操作时DSA机器的管电压、管电流和透视时间的资料进行统计分析,研究在介入手术治疗中影响吸收剂量的相关因素.结果:心脏冠状动脉支架术和室上速射频消融术所需透视时间最长,此时的管电流、管电压数值最大,因此应特别注意在行心脏介入手术治疗过程中的吸收剂量,并做好辐射防护.结论:合理应用DSA机器,正确使用缩光器、减少透视时间和每秒脉冲率是减少吸收剂量的有效方法     

冠心病伴糖尿病患者基于IVUS指导开展冠状动脉介入疗法的有效性分析

目的:冠状动脉粥样硬化性心脏病(简称,冠心病)伴糖尿病患者基于IVUS(血管内超声)指导开展冠状动脉介入疗法的有效性分析。方法:选择2019年7月~2020年4月于本院接受冠状动脉介入治疗的74例冠心病伴糖尿病患者为研究对象,参考患者入院时间以及37例单组区间条件划分为对照组(常规实施冠状动脉介入治疗)、IVUS组(基于IVUS指导开展冠状动脉介入治疗);比对两组造影剂使用量、支架置入数、支架直径、支架长度、手术成本。结果:IVUS组相对比对照组而言,造影剂使用量以及支架置入数较少,支架直径较大,长度较短,手术成本较低,差异统计学意义明显(P<0.05)。结论:基于IVUS指导对冠心病伴糖尿病患者行冠状动脉介入治疗,可减少造影剂使用量与支架置入量,且手术成本较低,有利于患者接受。