欧洲心脏病学会2017版急性ST段抬高型心肌梗死诊断和治疗指南更新之我见
洪涛
摘要(Abstract):
<正>2017年8月26日,欧洲心脏病学会(ESC)公布了最新版《急性ST段抬高型心肌梗死(STEMI)诊断和治疗指南》(以下简称2017版指南)较2012版指南相比,诊疗建议发生多处变化~([1]),但是有些建议不一定适合我国临床实际,在临床实践中还要依据自身实际情况制定合理决策。针对2017版指南的一些主要建议提出几点具体想法,以供参考。1 STEMI急诊经皮冠状动脉介入治疗(PCI)时
关键词(KeyWords): 急性ST段抬高型心肌梗死;欧洲心脏病学会;指南
基金项目(Foundation):
作者(Author): 洪涛
参考文献(References):
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