成人先天性心脏病-新指南和临床护理观点

N. Naser, Z. Kusljugic
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引用次数: 0

摘要

迄今为止,全球CHD患病率为每1000名新生儿约9例,存在很大的地理差异。过去50年来,世界上关于其起源、诊断和治疗的最新知识有助于对其进行护理。由于成年冠心病患者在高龄(包括老年人)中数量不断增加,因此成人冠心病一词不再合适,因此根据2020年发布的ESC指南,被成人冠心病(ACHD)所取代。由于过去几十年的医学、外科和技术的发展,>90%的先天性冠心病患者现在能活到成年。ACHD对临床医生来说是一个挑战。尽管有最佳的医疗和手术治疗,许多人仍会经历心肺功能的逐渐下降,导致晚期心力衰竭。严重的心室功能障碍和/或肺动脉高压可能无法进行矫正修复。他们在青春期的早期识别和随访将有助于更好地照顾这些患者。重要的是,对ACHD患者的护理是一个终生的过程,需要预先制定护理计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ADULT CONGENITAL HEART DISEASE – NEW GUIDELINES AND CLINICAL CARE PERSPECTIVE
To date, the prevalence of CHD worldwide is ∼9 per 1000 newborns, with substantial geographic variation. The latest knowledge in the world for the last 50 years about their origin, diagnosis and therapy has contributed to their care. Since adult patients with CHD now present increasing numbers at advanced ages, including the elderly, the term grown-up CHD no longer appears appropriate and was therefore replaced with adult CHD (ACHD) according to the ESC guidelines published in 2020 year. Due to medical, surgical, and technological evolutions over the past decades, >90% of individuals who are born with CHD now survive into adulthood. ACHD represent a challenge for clinicians. Despite optimal medical and surgical treatment, many will experience a progressive decline in cardiopulmonary function leading to advanced heart failure. Severe ventricular dysfunction and/or pulmonary hypertension may not be amenable to corrective repair. Their early recognition and follow-up in adolescence will contribute to better care for these patients. Importantly, the care for ACHD patients is a lifelong process and requires advance care planning strategies.
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