The arrhythmia gets involved and treats: What shouldn't be done is not done

The arrhythmia gets involved and treats: What shouldn't be done is not done
Staff reporter Tan JiaCardiovascular vessel disease gets involved and treats the straight newspaper system to start formally since July 1 this year, it is one of the straight newspaper contents too that the arrhythmia gets involved and treats. Ministry of Public Health is cardiovascular to get involved in to make a diagnosis the group leader of expert's work group of the technological standardard management, the intersection of Chinese and the intersection of medical science and knowing electric physiology and get up, fight the intersection of branch and alternate General Board, cardiovascular the intersection of disease and the intersection of hospital and Zhang Shu Professor, head of the department of internal medicine of heart, point out outside the the intersection of Chinese Academy of Medical Sciences and mound, strengthen the arrhythmia and get involved and treat quality control, put emphasis on mastering indication, procedure of standardizing operation strictly, it is the importance of promoting the development of the professional technique standardization of this field that pushes hands.The assurance to indication of some hospitals is improperAccording to the introduction of expert, and two slow big classes aroused in interest that the arrhythmia is mainly divided into aroused in interest fast, the former's involvement treatment is mainly to melt by the radio frequency of the conduit, that is to say that inserts the heart conduit in the heart from the peripheral blood vessel, until a plurality of position carry on electric physiology check in the to heart, in order to confirm some origin or key position of tachycardia, then melt to these positions through the electric current of radio frequency. This one has treated the way since in our country's clinical practice in 1991, has already become effective therapeutic method of many kinds of fast arrhythmia.Have getting aroused in interest slow person on suffering from, get involved, treat, plant pacemaker into mainly, return to normal to beat to lend sb. a helping hand for patient's heart. The pacemaker planted into can launch the pulse electric current of certain frequency, transmit to the atrium or ventricle skin through the wire electrode, stimulate some myocardium cells to produce excitement, and then cause the whole atrium sum ' Or) The shrink of the ventricle, achieve the goal of keeping normal heartbeat. The pacemaker is the internationally acknowledged and effective and safe heart apparatus therapeutic method, employing in our country has quite long period too, have notable effect in treating interesting slowly. In recent years, the application in sudden cardiac death in heart failure gets rapid development too. Pace maker can tape defibrillate function, prevent sudden cardiac death, to melt, get up, fight, can also treat in heart failure effectively synchronously a plurality of position also.At present, thousands of hospitals, thousands of doctors are launching the involvement treatment of the arrhythmia nationwide, there are more than 40 to launch arrhythmia and get involved in hospitals treating in Beijing area. Not long ago, Zhang Shu participated in the cardiovascular quality of getting involved in Beijing and improved the expert supervision activity of the centre, find in the supervisor some hospitals have indication to hold the improper problem.Zhang Shu proposes, on the assurance of getting involved in indication, should combine patient's heart function, whole body state, amalgamate factors such as disease, psychological state, economic state,etc. to consider synthetically, carry on radio frequency melt once finding the tachycardia, getting aroused in interest and slow to plant pace maker into right away. Patient appear tachycardia, room quiver, room fight, some room arrhythmia break out repeatedly only when, when the medicine fails to respond to any medical treatment, can choose the radio frequency to melt; At patient it is aroused in interest too slow,it reach by 50 times /under second,it is stop not beating not to present,and with at the time of symptoms clinical, just need to install the pace maker. One that is with clinical symptom aroused in interest refers to slowly directly because the heart rate is too slow, the blood supply is insufficient and presents symptom of faint, is similar to fainting, dizzying etc..Zhang Shu especially briefs on, when the radio frequency melts and gets involved to treat, must hold and treat degree strictly, otherwise apt to have too much of a good thing, " after some patients finish the radio frequency and melt, because the heart was jumped over slowly and needing to install the pace maker. "Any link can't make mistakesArrhythmia get involved, treat, may appear various complication, such as blood vessel wounded and hemothorax or pneumothorax, the intersection of artery and thromboembolism, heart punch and acute left heart decline, anaesthetize unexpected, etc, some may be very serious, even cause patient death.It is reported, before the arrhythmia gets involved and treats the skill, needed clear heart disease diagnosis to the patient, whether with organic heart disease; For planting into the patient of the heart defibrillating device, should define treatment is for first class prevention, second prevention; The doctor is right to it takes to mark the arrhythmia examining or melting " Know what's what " ,Sex tachycardia, room tachycardia are still room tachycardia,etc. on the popping room.Zhang Shu emphasizes, the doctor must highly look out, acts according to the operation regulation strictly, in front of the skill, in the skill and postoperative the link can't adopt a casual attitude, appear perhaps " operation very much beautiful ", patient but death " Result. Adequate preparation before the skill, blood vessel route to operate in the skill and getting involved in the choice of the apparatus, with which kind of operation can reach most satisfactory the intersection of operation and result, postoperative guard and use medicine and strict postoperative the intersection of person who follow up a case by regular visits to and content, the doctor should all be clear on the heart, and tell to a patient.Zhang Shu proposes, postoperative management and following up a case by regular visits to is very important. Regard planting the example into the pacemaker as, this increasingly automated heart pulse launcher is while offering the frequency of heart to patient and supporting, also may cause the harmful effects to the patient. So need the doctor to track tightly to the patient, follow up a case by regular visits to for a long time, find various influence that the pacemaker brings to patient in time, take the effective measure to intervene in time.Improve the quality and accuse of the system to guarantee the norm is implemented"How to guarantee the norm can be fulfilled, need quality control system to go on ' control '. " Zhang Shu says, Ministry of Public Health issues " technological standardard management of getting involved and making a diagnosis of of the cardiovascular vessel " in July of 2007, to launching organization, personnel's entry, qualification asserting and medical quality control of training base of technology of this medical care, evaluating and examined and all proposed the clear requirement. As the normal important component, quality control is the last ring, it is a ring that has the actual effect most too.The hospital's own quality accuses of the system and should be held first " The first barrier " . According to the introduction of Zhang Shu, Fuwai Hospital has made and got involved to treat the procedure norm earlier, have specially established and got involved and treated the expert panel, is responsible for to paying asserting in cardiovascular qualification of doctor treating of getting involved. The doctor must accept the training of a regular period, and finish enough case, operation complication incidence and is not higher than average level under the guidance of doctors of higher authorities, it is qualified to carry on the independent involvement treatment. In addition, Committee of Experts also organizes discussing to difficult case, death case, when finding one doctor gets involved the death case of the treatment, complication incidence are raised, need to analyze, can suspend his operation qualification if necessary."The drivers have all studied traffic rules before setting out on a journey, but in violation of rules and regulations and still many after setting out on a journey. Getting involved and treating the norm faces the same problem too. " Zhang Shu says, should guarantee the norm can be carried out conscientiously, there must be strict control system and measure. The straight newspaper system is an enormous monitoring platform if the whole country that begins to be launched formally since July 1 this year is cardiovascular to get involved, can find, catch to in time " Violation " The signal, and send out and warn.As the person in charge of not normal straight newspaper system of rhythm of the heart, Zhang Shu introduces, in the frank newspaper system, basic information of the person who gets involved patient and skill of treating of every arrhythmia, whether general data, basic situation, operation of planting into medical equipment of the operation have contents such as complication, death case,etc. that need appearing in the newspaper in time. The quality accuses of being responsible for counting, analyzing to reporting the data the centre. When the operation example of one hospital or one doctor is counted and fluctuated, case increasing, complication incidence dies to rise, the quality will be sent out and warned in time in the centre when being accused of. Quality accuse of report tell medical organization written form whether notify, rectify and improve if necessary, and advise health authorities to further deal with. Obtain health authority permit, quality accuse of centre release professional the intersection of examination and scheme, quality, accuse of the index and result of appraisal to the outside also, "it is not that the strength of the administrative department warns, supervises medical organization and doctor that got involved and treated to depend on public media,etc.. "In addition quality accuse of centre go hospital carry on supervisor regularly also, verify case history, check relevant the intersection of operation and operation,etc., and organize the meeting of expert panel, revise and improve relevantly and manage the procedure in time, will represent that operates the procedure, clinical guide,etc. to incorporate in the relevant standardard management in standardization of the international most advanced level in time.
|