目的 总结GuideLiner®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。
Objective To evaluate the clinical efficacy and safety of GuideLiner® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.
李俊,广东省名中医,从事中医临床工作30年,尤擅长经方“峻剂轻投”治疗疑难杂症,主张根据病情需要,从小剂量用起;根据脾胃功能,以小剂量取效;根据慢性病的特点,以小剂量调治;根据个体差异,以小剂量获效;并注重杂合以治疗。
目的 介绍基层妇幼保健院成功开展126例小儿先天性心脏病(先心病)外科治疗经验。方法 2018年9月开始,在基层妇幼保健院设立小儿先心病治疗中心,开展小儿先心病外科治疗。结果 共收治126例小儿先心病患儿进行先心病手术治疗,全部痊愈出院。结论 在有经验的先心病治疗中心的协助下,基层妇幼保健院可以成功开展小儿先心病外科治疗。
目的 总结GuideLiner®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。
Objective To evaluate the clinical efficacy and safety of GuideLiner® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.
目的 为构建更加健全和可靠的医保体系，制定有效、公平和可持续的医保支付方式提出建议。方法 对医保支付方式及各地医保支付方式改革的实践进行综合比较，总结改革的效果和经验。结果 通过引入绩效导向的支付机制、推动综合付费方式、细化按疾病阶段付费、结合互联网医疗、强化数据能力、健全监管等方面推进医保支付方式改革。结论 医保支付方式是规范医疗机构和医生医疗服务的重要手段，结合浙江省、广东省广州市等省市积极探索疾病诊断相关分组、按病种分值付费等医保支付方式，改革需要综合考虑医疗体制、经济发展水平、人口结构等各方利益和多个因素，通过综合实施，构建更加有效、公平和可持续的医保支付方式。
Objective Provide suggestions for building a more sound and reliable medical insurance system，and developing effective，fair and sustainable medical insurance payment methods．Methods The payment methods of medical insurance and the practice of medical insurance payment reform in various regions were comprehensively compared the effectiveness and experience of the reform were summarized．Results The reform of medical insurance payment mode was promoted by introducing performance-oriented payment mechanism，promoting comprehensive payment mode，refining payment by disease stage，combining Internet medicine，strengthening data capability，improving supervision，etc．Conclusions The payment method of medical insurance is an important means to standardize the medical services of medical institutions and doctors．In combination with the active exploration of Diagnosis Related Groups，Diagnosis Intervention Packet and other medical insurance payment methods in provinces and cities such as Zhejiang and Guangzhou Guangdong．The reform needs to comprehensively consider the interests and multiple factors of the medical system，economic development level，population structure，etc．To build a more effective，fair，and sustainable medical insurance payment method through comprehensive implementation．
