专家共识
急性冠脉综合征急诊快速诊治指南(2019)
中国医师协会急诊医师分会
国家卫健委能力建设与继续教育中心急诊学专家委员会
中国医疗保健国际交流促进会急诊急救分会
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DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003
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摘要

急性冠脉综合征(acute coronary syndromes,ACS )是指冠状动脉内不稳定的粥样硬化斑块破裂或糜烂继发新鲜血栓形成所导致的心脏急性缺血综合征,涵盖了ST段抬高型心肌梗死(ST elevation myocardial infarction, STEMI)、非ST段抬高型心肌梗死(non ST elevation myocardial infarction, NSTEMI)和不稳定性心绞痛(unstable angina,UA),其中NSTEMI与UA合称非ST段抬高型急性冠脉综合征(NSTE-ACS)。ACS的发病率在我国依然呈逐年增加的态势,而且绝大多数ACS患者首诊于急诊科。2016年4月,中国医师协会急诊医师分会邀请中华医学会心血管病学分会、中华医学会检验医学分会、中华医学电子音像出版社共同制定并发布了《急性冠脉综合征急诊快速诊疗指南》 [ 1 ] ,对于缩短ACS患者从首次医疗接触(first medical contact, FMC)到治疗的时间、规范ACS的急诊诊治流程、尤其强化包括静脉溶栓在内的早期再灌注治疗起到了积极的指导作用。3年来,ACS的诊治又取得了重要进展,为保证学术的先进性,并在实践上与国内外新的指南相接轨,中国医师协会急诊医师分会与国家卫健委能力建设与继续教育中心急诊学专家委员会、中国医疗保健国际交流促进会急诊急救分会组织、会同相关专家对2016年的《急性冠脉综合征急诊快速诊疗指南》进行修订,发布《急性冠脉综合征急诊快速诊治指南(2019)》,进一步推进ACS在急诊科(含院前急救)与相关学科的科学化管理。

引用本文

中国医师协会急诊医师分会,国家卫健委能力建设与继续教育中心急诊学专家委员会,中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志,2019,28(4):421-428.

DOI:10.3760/cma.j.issn.1671-0282.2019.04.003

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急性冠脉综合征(acute coronary syndromes,ACS )是指冠状动脉内不稳定的粥样硬化斑块破裂或糜烂继发新鲜血栓形成所导致的心脏急性缺血综合征,涵盖了ST段抬高型心肌梗死(ST elevation myocardial infarction, STEMI)、非ST段抬高型心肌梗死(non ST elevation myocardial infarction, NSTEMI)和不稳定性心绞痛(unstable angina,UA),其中NSTEMI与UA合称非ST段抬高型急性冠脉综合征(NSTE-ACS)。ACS的发病率在我国依然呈逐年增加的态势,而且绝大多数ACS患者首诊于急诊科。2016年4月,中国医师协会急诊医师分会邀请中华医学会心血管病学分会、中华医学会检验医学分会、中华医学电子音像出版社共同制定并发布了《急性冠脉综合征急诊快速诊疗指南》 [ 1 ],对于缩短ACS患者从首次医疗接触(first medical contact, FMC)到治疗的时间、规范ACS的急诊诊治流程、尤其强化包括静脉溶栓在内的早期再灌注治疗起到了积极的指导作用。3年来,ACS的诊治又取得了重要进展,为保证学术的先进性,并在实践上与国内外新的指南相接轨,中国医师协会急诊医师分会与国家卫健委能力建设与继续教育中心急诊学专家委员会、中国医疗保健国际交流促进会急诊急救分会组织、会同相关专家对2016年的《急性冠脉综合征急诊快速诊疗指南》进行修订,发布《急性冠脉综合征急诊快速诊治指南(2019)》,进一步推进ACS在急诊科(含院前急救)与相关学科的科学化管理。
推荐类别:Ⅰ类为已证实和(或)一致认为有益和有效;Ⅱ类为疗效的证据尚不一致或存在争议,其中相关证据倾向于有效的为Ⅱa类,尚不充分的为Ⅱb类;Ⅲ类为已证实或者一致认为无用或者无效,甚至可能有害。
证据水平:证据来自多项随机对照临床试验或者多项荟萃分析为A级;证据来自单项随机对照临床试验或非随机研究为B级,证据来自小型研究或专家共识为C级。
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