彩色多普勒超声心动图对尿毒症性心脏损害的诊断价值

本文回顾性分析76例尿毒症性心脏损害患者彩色多普勒超声心动图检查结果,探讨其对尿毒症性心脏损害的诊断价值。     

经食管超声心动图在心外手术心脏辅助中的应用

心脏辅助技术在终末期心脏病或濒死心脏病的应用，是近年来心脏外科治疗方面最重要的进展之一。目前，心脏辅助在临床上最常见的适应症包括：1．心脏直视术后严重低心排；2．大面积心肌梗死；3．心脏移植术前后。     

全身麻醉药对蒽环类药物化疗后患者围手术期心脏影响

背景 蒽环类药物因其良好的抗肿瘤特性被广泛应用于各类血液系统肿瘤及实体肿瘤、如淋巴瘤、软组织肿瘤、乳腺癌、胃癌、卵巢癌等.但在其应用于临床后不久即被报道出有严重的副作用,包括骨髓抑制以及致命性的心脏毒性. 目的 旨在探讨全身麻醉药对接受过蒽环类药物化疗后患者围手术期心脏功能的影响. 内容 综述用于乳癌新辅助化疗的蒽环类药的心脏毒性、蒽环类药物治疗后的患者围手术期心血管危险事件及心脏保护策略. 趋向 临床麻醉中应重视蒽环类药物本身对心肌细胞的影响,合理用药和管理,减少围术期对蒽环类药物治疗后的患者的影响,降低其围手术期心血管危险事件发生率.     

单用蒽环类与紫杉醇+蒽环类在LuminalA型乳癌疗效的对照研究

目的 回顾性研究Luminal A型可手术乳腺癌患者在含蒽环类的化疗方案之上加用紫杉醇类是否能提高患者的无病显存率( DFS)及总生存率(OS).方法 收集2006年1月到2009年1月可手术乳腺癌患者126例,根据化疗方案不同分为两组,紫杉醇(T)组83例,蒽环类(A)组43例.回顾性分析两组患者的年龄、肿物大小、淋...     

Improving the therapeutic index of anthracycline chemotherapy: Focus on liposomal doxorubicin (Myocet™)

Anthracyclines are valuable cytotoxic agents in cancer treatment. However, their usefulness is limited by cumulative dose-dependent cardiotoxicity that may manifest as life-threatening congestive heart failure. To avoid cardiotoxicity, the use of doxorubicin is typically capped at a safe cumulative dose. Liposomal formulations may reduce cardiac risks whilst maintaining anti-cancer efficacy.Efficacy and safety studies of non-pegylated liposomal doxorubicin (NPLD) in metastatic breast cancer (MBC) are reviewed, along with studies that examine efficacy and cardiac tolerability in combination with newer agents such as paclitaxel and trastuzumab. These show that cardiac safety of liposomal doxorubicin is similar to that of epirubicin in cumulative dose, but that the formulation, unlike epirubicin, has similar anti-cancer efficacy to doxorubicin at equimolar doses. Liposomal doxorubicin may have a better therapeutic index than non-liposomal anthracyclines. This justifies further studies in patients where cumulative cardiotoxicity is a concern, as does study of its use with other potentially cardiotoxic agents.     

超声心动图预测心房颤动患者左心房血栓形成

心房颤动(房颤)可促进左心房血栓形成,而血栓脱落后引起的血栓栓塞是其最严重的并发症之一。准确预测房颤患者左心房血栓的形成,对房颤术前风险评估及临床抗凝治疗方案的选择有重要价值。超声心动图具有无创、经济等优点,可为预测房颤患者左心房血栓的形成提供可靠信息。     

Echocardiography in cardiac anaesthesia and intensive care

Echocardiography or cardiac ultrasound has long been established as an important cardiac imaging technique for acquiring real-time information about cardiac anatomy and function. The technological aspect of this cardiac ultrasound platform continues to evolve, recent developments such as real-time 3D scanning are currently being assimilated into clinical practice first in transthoracic scanning and now in transoesophageal scanning. Echocardiography use is migrating across patient populations and different specialities – there is currently much discussion on how best to adopt the technique for the general intensive care unit. Cardiac assessment and monitoring have always been an essential part of the management of the patient undergoing cardiac surgery and cardiothoracic intensive care (CTICU). Echocardiography additionally gives a diagnostic benefit and provides an immediate point of care assessment of surgical procedures. High quality training programmes are essential for the recognition and acceptance of the anaesthetist or intensivist echocardiographer. This review covers the more recent clinical aspects, training issues, technological advances and future developments in relation to these areas.